HomeMy WebLinkAboutCancellation of PermitOdd ITS+''
F L 0 R 1 0 A
PLANNING & 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.
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: 12/1 /20
Site Address: 1203 Driftwood Lane, Ft. Pierce, FL 34982
Tryon Plumbing Inc.
Original GC, subcontractor or owner/builder
New GC, subcontractor
Permit Number: 2009-0605
License CFC058068 SLC License 19738
License SLC License
Reason for Cancellation Solar Hot water panel was broken, could not re -install
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 OWNElC r owner/build )
PRINT NAME��
State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this
I day of w 20Zd, by
r who has
4
of Notary
who is personally known to me
Io
KARLEY MARIE GIESYNARNEY
Notary Public — State ofFlorida
'
Commission
Revised 04/IS/I
Ate;`
ll00099E01
My Comm. Expires May 1,2021
„on��•'
Bonded through National Notary Assn.
SIGNATURE GENERAb-COX TO`R�s as applicable)
PRINT NAME Robert Tryon
State of Florida, County of St. Lucie County
The following ' strument was acknowledged before me this
day of De 20ZC by
who is personally known to
me or who hYa produced as ID.
Sign of Notary Date �r
1.4
KARLEY MARIE GIESY-VARNEY
Notary Public - State of Florida
Commission M GG 099801
_' My Comm. Expires May 1, 2021
�F`•"' Bonded through NaBonalNotary Assn.