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HomeMy WebLinkAboutCancel, void permitPlanning & Development Services Building & Code Regulations Division 2300 Virginia Ave. 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 contractor information, 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: pp Permit Number: OKV -" �% Site Address: "f .� 5 �) s ` -Port- S+ j u State License �SJ �Va License Original Gei� i�eral ContraUr (or Subcontractor) State License SLC License New General Contractor (or Subcontractor) Reason for Change Uu('tk doseAae � _by/ D 1yo Fends, 47j f/i sAA 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, which may arise as a result of this change of contractor/subcontractor or cancellation of permit. A permit cannot be cancelled if work has been performed. SIGNATURE OF OWNER (or owner/builder) *SIGN OF NEW ERAL CONTRACTOR PRINT NAME PRINTNAMr� ' Wmyi State of Florida, County of St. Lucie County State of Florida, County of St. Lucie County The following instrument was acknowledged before me this day of , 20 , by who is personally know to me or who has produced as ID. Signature of Notary Date The following instrument was acknowledged before me this day of �13 G7T , 2�), by ©—S 1� who is personally know to me or who ha produ d as ID. / rl '�a / / Signature of Notary Date *Only signature required for change of subcontractor Revised 07/21/14 Ml hdo J. BMM NOTARY PUSUC STATE OF FLORIDA Co nn* 000303M Expires 10/1/2020