HomeMy WebLinkAboutChange of Contractor r ;:e'r. -<r•' PLANNING&UEVELOPAWNT SERV__ICES .
BURDING&ZONING RTVISION ` RECEIVED
2300 V]RGMA AVE
JUL 2 ��2020
FORT P,XERGE,FL 34982 ,
(772)4b2-1553 M 452-1578 ST. Lucie County, Permitting
CCEMGE OF CONTRtACTM SURCONT A,CTO OR C NCEL�,ATTM OF PERMT
PLEASE SELECT ONE OT THE Pdl. O G;
CHANGE OF CONTRACTOR•-Change of Contractor is to be signed and notarized by the property owner,
and the new eo>attktor of record for the current permit.A new permit application must also be completed with new
contractor infou natiotl and signature.'A new Notice of Conmencement must be filed in the new coutractoes name
for job values greater than $2,500 ($7,500 if A)C Change-out). A recorded copy must be submitted prior to
commencing any work.There_is a$50.00 fee for the Change of Contractor.
CHANGE OF SUBCONTRACTOR--Subcontractor changes are to be completed by the general contractor.
The new subcontractor must fill out a Subcontractor Agreement Form,There is a$50.U0 fee for-the Change of Sub-
>a tar.
ANCELLA.TIION OF PERMf'T-The cancellation of a permit is acceptable only if no work has been done.
tia>a of permit is,to be signed.and notarized by both the oviner and qualifier of record. There is no fee for .
cancellation of the permit.
,Hate: Permit Number-, 1602-0360 -
Site Address: 13627 S INDIAN RIVED DR,JENSEN REACH,Fl,34957
EDEN SCREEN&CONSTRUCTION CO.,INC State License G8G 059494 SLC Ncease
Origtnal GC,subcontractor or owner/builder
_State Licew SL C-Licease
—Now GC,subcontractor
Reason for Caucellation CUSTOMER CANCELLED JOB,NO WORK STARTED
The undersigned does hereby agree to ixrdetatiify and hold harmless St Lucie County,its—of ficers,agents and employees from all.
costs,fees or damages Arising from any and all claims of action for any reason,wWoh may arise.as a result of this chmge of
contxa r/subcouutlractor or cancellation of permit.A,permit cannot be eaveelled if wo7rX has been performed.
F �
`SIGNATM O1:o Elt(or owner/builder) SIGNATURE G NERAL CONTRACTOR(or new GC,as applicable)
PRIMT ,An ROBERT HERITAGE JON LEVASSEUR
state of Pluida,Colmty of St Lucie County State of Florida,County of St L cio county
The f iliwming instxa eat was aclmowladgeabefore me this 1tow�
.. i tams aclmawledgeA beforeme tbi6 .
t C� ��� �'daf'og J (X� ,20.Mby
day of ii :� zo_(j by r
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Signature of Notary; ,,�� .." ,ir�i Slgtiature of Notary ! Date ° C ° �ggION �dy
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ttevized 04/15/16 :yyG
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