HomeMy WebLinkAboutChange of Contractor- - --- -- - -- PLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION RECEIVED
COUNTY2300 VIRGINIA AVE NOV 05 2020
- - FORT PIERCE, FL 34982
Permitting Department
(772) 462-1553 FAX 462-1578 St. Lucie County
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.
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 $50.00 fee for the Change of Sub -
Contractor.
1 H1-0 CANCELLATION OF PERMIT — The cancellation of a permit is acceptable only if no work has been done.
Cancellation of permit is to be signed and notarized by both the owner and qualifier of record. There is no fee for
cancellation of the permit.
Date: 10/28/2020
Site Address: 11 HIDALGO
Irir� (i! I � I � :I g11S71i LtZ$�l�
Original GC, subcontractor or owner/builder
New GC, subcontractor
Permit Number: 2005-0291
LicenseZA SLC License S12k C) a
License SLC License
Reason for Cancellation DO NOT NEED THIS PERMIT, NO WORK BEING DONE HERE
The undersigned does hereby agree to indemnify and hold harmless St Lucie County, itsofficers, 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/subcontrac ellation of permit. A permit cannot be cancelled if work has been performed.
SIGNATURE OF OWNER (or owner/builder) SIGNATURE GENE CONTRACTOR (or new GC, as applicable)
PRINT NAME MATTHEWWYNNE PFINTNAME ERIC WYNNE
State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this
,? day of 40 G`rb�if922010 by
MATTHEW WYNINE who is personally known to me
or who has produced as ID.
gQ,P{r.,10/2812020
Sig a ure of Notary Date
Revised ';:, DOROTHYANNgASKIN
MY COMML
HH 045443
A�j�OFP`ePo, EXPIRES.
�h r2,2124
ic lhtden yhm
State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this
•- day of OC- pd20,il7by
ERIC WYNNE who is personally known to
me or who has r duced as ID.
0/28/2020
Signature 6&otary Date
t •. DOROTHYANN BASKIN
MY COMMISSION tl HH 045443
EXPIRES: Ocbber2,2024
,�'•FOOF F ��P'', Bond Timw. N Not Pubic u B