HomeMy WebLinkAboutcancellation notciePLANNING & DEVELOPMENT SERVICES
BUILDING & ZONNG DIVISION
COUNTY
2300 VIRGINIA AVE
FORT FIERCE, FL 34982
(772) 462-1553 FAX 462-1578
CHANGE OF CONTRACTOR — Change of Contractor is to be signed and notarized 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 and signature. A new Notice of Commencement must be filed in the new contractor's name
for job vahics grater 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 $50.00 fee for the Change of Sub -
Contractor.
X CANCELLATION OF PERMIT — The cancellation of a permit is acceptable only if no work has been done.
Cancellation of permit is to be signed and notarized by both the owner and qualifier of record. There is no fee for
cancellation of the permit.
Date: Sept 30, 2020
Site Address:
Agler Kitchen, Bath & Floors, Inc
Original GC, subcontractor or owner/builder
New GC, subcontractor
Permit Number: 2009-0490
License CBC1260837 SLC License
State License SLC Licevsc
Reason for Cancellation Client hasn't purchased the unit yet. Changed mind on doing work
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 ai! claims of action for any reason, which may arise as a result of this change of
contractor/subcontractor or cancellation of permit, A permit ettidn t be cane led=ork b n performed.
SIGNATURE OF OWNER or owmurlhuilder
t � 4 SIGNATURE Cil?�1FR{IL CONTkACTdlt (or new GC, as applicable)
PRINT NAKE Linda Pollack
State of Florida, County of St Lucia County
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Sept 30, 2020
Signature of Notary ]late
Revised 0411511 •.• SANDY M. FREUDENTM
Commission i GG 169508
A: ExOres December 19, 2021
Boded Tt nr Troy Fain Isswence NO- S-7019
f%WT NAME K. LaDeene Dodson
State of Florida, County of St Lucie County
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Sept 30, 2020
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Commission i GG 1695M
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