HomeMy WebLinkAboutSandler Cancelation of PermitPLANNING & 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.
e CANCELLATION OF PERNUT -- 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; 12-18-2020
Permit Number: 2012-0086
Site Address: 8880 S.Ocean Dr Bldgl Apt 907, Jensen Beach ,FL 34957
Franco Construction Inc
Original GC, subcontractor or owneribuilder
New GC, subcontractor
License GGC1512181 SLC License
License SLC License
Reason for Cancellation Permit hasnt come into start job and we could no longer complete job by requested date
The undersigned does hereby agree to indemnify and hold harmless St Lucie C unty, its ofR
gents and employees from all
costs, fees or d ges arisin om any and all claims of action for any yeas , which may a result of this change of
contractor/ contractor cellation of permit. A permit canno a celled if work n performed.
GNATURE OF OWNER (or owner/builder) IGNATURE GENERAL CON i1tACTOR (or new GC, as applicable)
PRINT NAME 6L,1G0 PRINT NAME f M t .�--
State of Florida, County of SL Lucie County State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this
___day of t C 20 by
j%l tl L U L�- Lo who is personally [mown to me
,or who has produced as ,
Oj,,✓!_ 12- -2020
Signature of Notary Date
The following instrument was acknowledged before me this
t jjQL-day of DeL 2od,J by
who is personally known to
me or who has produced 'F110L P.
l 6L t V),C-. 12- -2020
Signature of Notary Date
Revised 04/15/16 _ SAYPV •. TAMARAA[ROUSE
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F+Notary Pubtic -State of FloridaCommission M GG 959268
My Comm. Expires Jun 12, 2424
Banded through NataonaI Notary Assn.