HomeMy WebLinkAboutEISEMAN CHG OF CONTRACTORPLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578
CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMT
PLEASE SELECT ONE OF THE FOLLOWING:
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 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.
XX 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.
_ 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: 11/5/2020
Site Address: 1215 W JOY LANE FT PIERCE
CENTRAL AIR SYSTEMS
Original GC, subcontractor or owner/builder
JUST CHILLIN
New GC, subcontractor
Permit Number: 2002-0158
License CAC054741 SLC License
License CAC1819351 SLC License
Reason for Cancellation CUSTOMER DECIDED TO GO WITH DIFFERENT AC CONTRACTOR
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/subconftaqpr or cancellation of permit. A permit cannot be cancelled if work ha been performed.
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SIGNATURE OF OWNER
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State of Florida, County of SL Lucie County State of Florida, County of St. Lucie County
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