HomeMy WebLinkAboutCancellation request formP t .,\ -\ N I N C & D l,t v t._ 1,() t,[,] tiN't' s ti tt\rI c E s
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{777\ 462-1553 t-,\\ 462-t 578
{'rr.\N(;F. oI: c{)\'rR.\{t't'oR. suB('o\TIr \(. [(]R O!t C,.\NCELLA'r'It]N OF I]I.r_u]r"t'
PL hA\l \Ft FI I (l\lp (iF Titi i;i-ri i (livi\(,'
-CHANGE
OF CONTRACTOR - Change of Contrar-'tor is to be signed and notarized by the propcrly owncl.
andthelrewLrDtltlaclorofl'cr-otd tbrthe currellt pcrmil- A nevr,perrnit applicatiorr tuust also t". c.rnrplcted with ncw
ctiltlractor inlbrmation rrrd sigrrature. A new Noticc ol C'c'rnnrcncelrlent tngst be t-ilcd in the new coltrae:lor's rranrc
lor job values grearter rhan 52"500 (57.500 if A/C Churrgc-out). A rccortled copy must bc suhrnitrctl prior to
crrrnnlcncing any work. 'l'here is a $50.00 fee l'or f he Changc of Contractor.
--CHANGE
Of SLIBCON'|'[L'\.C1'OR - Sttbcontractor charrges rtrc to he ct-rnrplctetJ by the general conrrircror.
Thc tieu' stltrc$ntl'acfor rnusl fill <lttt a Sulrcontrat-tor' .AgTec'mcnt Forrl. Thcre is a{50.00 fee for the Change of Sul>
ry:'HCELLATION oF PERTYIT - The canccllation of a pernrit is acceprable only ir no work has b..-u-D rlt)re.
Clance llalion of pernrit is to he signcd and notarizcd by Lrtrth the owner antl qullitier of r-et-ortJ. Therc is no fce firr
carlcdlation of tlrr pernrit.
$atc: 09.16.2 perrnit NrrrnSer: 1s05-0437
Site Addresr. 10851 S Ocean Driv* 48. Port St Lucie.Fl
Air-Ref Conipany, lnc.
O ri giual CC. subcirntratjl or or crrvncri/bu i ldrr
Ncrl G(-. sutrcorrl lttct<-rr'
llcusiru litr Caurc..llario,., Owner cancelled the job
te i_iceiiir CBC05g453 \i-tl l-iccnsc
it*r'ri:r,y agrtrd to indenrnilv and hold harn-rlcss St Lucie County,, its otficers. ilgcnt.,i ald ernpl6ygg5 fiorn all
arising frtlnr arry and all clainrs of action tbr any rcdson. which may arise as a r(stttt of this change of
or rcrnce ltation of penrril. A prrmit
!'i.]*ljT lr:'riltr
il-ttltu h;r.
Strte of FIli.h- {- torrty trf St- l-tti* Cr,rlrrv
Thc lqll,'r irrg !n\f r trrlicrlt q:g nfiirh,wle,Jg.J bllir" rru rhis
b-fr a*r,ul SqrM :o Ao. av * ila a rEZ*pldoy. a O _..*rvhtr is ptr'-,alllh kn.ayn tu riiu
rannol be carieellett if rrork.has bee-r pcrlbrnrerl.
'-''.t:'- '- :- ' -- .----
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\lCti,{TURtl fit:NllR}"L (B\-i.lt-,\CT|]R irrr *r* {jii. as aFi-iirai'iri
pnr.\-rN.c\lE Thornas L Cuenot
St,rt< oiFftirida, C,.urrty of St. I r11j!'{-r,,r1r1ly
TJrc fiilk'iting it-Lutrunxnt \rirs irlti.rrsl(,dr(.d Iklirrc ni. rhr\/{,'a ,tnv niJ'ry.iL .3u"4i, hy'i* u**-€:l:dd- sF ul,o is p!-!-:r!!rj]y.br.r:.rrp ro
_as ll).
09.'t6.20
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09.16.20
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Signlture of I):rlr
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Jlrt3 hd.ryPuDtrcSEbdFrufirl Snartne F Zqa{hnex*r &mmo?,G"*
PAUL $I}HGEHIS
MY CCSMISSiOi{ # G6 28n17
EXPIIIE$: FekuarY 8, 2t23
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.. .-Stat."- License_SlC License
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