HomeMy WebLinkAboutChange of Contractor; RoofingCOUNTY""-,
FLORIDA
Planning & Development Services
Building & Code Regulations Division
2300 Virginia A vc.
Fort Pierce, FL 34982
(772)462-1553 Fax 462-1578
CHANGE OF CONTRACTOR
Or Subcontractor or Cancellation of Permit
Change of Contractor is to be completed by the property owner , and the new contractor of record for the
current permit. A new permit application must also be completed with new contrac tor infonnation,
signature, and transfer fee . A new Notice of Commencement must be filed in the new contractor's
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. Subcontractor changes can be completed by the general
contractor. Absent extenuating circumstances, a cancellation of permit is to be executed by both the
owner and qualifier of record.
Date: 91312020 Permit Number: 1904.{)354 -----------
Site Address: 2414 N 53rd St Fort Pierce Fi
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Original General Contractor (or Subcontractor)
Reason for Change fg.GVI 00 S l6 ~ t>t ~r:::::,. ,
The undersigned does hereby agree to indemnify and hold harmless St. Lucie County, its officers,
agents, and employees from all costs, fees, or damages arising from any and all claims of action for
any reason, · ch may arise as a result of this change of contractor/subcontractor or cancellat ion of
rmit cannot be cancelled if work has been performed.
wner/builder)
PRINT NAME \~. l-Jkt.,~
e me th is
now to me
S E OF NEW GENE RAL Cl;CTOR/
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r e qu ired for c h a n ge of s u b contractor
Revi s ed 0 7 /2 1 /1 4
PERMIT# 1904-0354 ISSUE DATE
iJilllUD@·J '"-
COUNTY .
FLORIDA
PLANNING & DEVELOPMENT SERVICES
BuiJding & Code Compliance Division
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
---4-!--13--AJ-o=:.::wc.....:lic...:... • .:.i...;~ e""'--~/(~QJ~~:.....:.l~..,,f._-fo'1.!...!<C.c_, __________ have agreed to be
(Comp~ Name/lndividualMame)
the /~t,)if!/. Sub-contractor for Innovation contracting
(Type ofT~e) (Primary Contractor)
For the project located at 2414 N 53rd st Fort Pierce FL
(Project Street Address or Property Tax ID #)
It is understood that, if there is any change of status regarding our participation with the above mentioned
project, the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the
filing of a ge of Sub-contractor notice.
PRINT NAME
~(;(._/ t 7 /'// ~
COUNTY CERTIFICATION NUMBER
State of Florida, County of S1'· Lvlte
The foregoing Instrument was signed before me this _!_ day of
STAMP
Revi sed 11/16/2016
Scrr !]erKeld
PRINT NAME
CCC IJ.JoJq tl
COUNTY CERTIFICATION NUMAER
State of Florida, County of ~I .WU e
,s
The foregoing Instrument was signed before me this __ day of
STAMP