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Home My WebLink AboutChange of Subcontractor- Roofing Bldgs A-F_ = PLANNING & DEVELOPMENT SERVICES COUNTY - 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 F L G: 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. X 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 $50.00 fee for the Change of Sub - Contractor. CANCELLATION OF PERMIT — The cancellation of a permit is acceptable only if no work has been done. Cancellation of permit is to be signed and notarized by both the owner and qualifier of record. There is no fee for cancellation of the permit. Date: 2IW2021 Permit Number: 2010-0252 Site Address: 9563 S. Ocean Drive, Jensen Beach 34957 L&W Roof Systsms, Inc. State License CCC1327127 16087 SLC License Original GC, subcontractor or owner/builder J.A. Taylor Roofing, Inc. State License CCC1325720 SLC License 23018 New GC, subcontractor Reason for Cancellation The undersigned does hereby agree to indemnify and hold harmless St Lucie County, its officers, agents and employees from all costs, fees or damages arising from any and all claims of action for any reason, which may arise as a result of this change of contractor/subcontractor or cancellation of permit. A permit cannot be cancelled If work has been performed. SIGNATURE OF OWNER (or owncrr/builder) SIGNATURE GENERAL CONTRACTOR (or new GC, as applicable) PRINT NAME �IeJe. PRINfNAME State of iZ ends, County of Su uaiaCouatY State of Fkaida, County of St Lucie County �e ollowing instrument w as sclmowwn,Z��mr_l this _ c ss3w is taswaC�� kaownlmown to me who hp poducOas ID. 2!8/2021 signature of Notary Date foaowmg instrument was aclmowledged be c me�tia dayof�,20$S, by_K tay'Itlo who is o �Stt who has produced ss M. 21=021 skim we a ot"y Date Revised 0 � ASHLEY HEM 1ODk " El"ON Notary public -State of Florida N GG 072280 ••�•'� �► * " S HH 019©88 E>�n Jaettaryi1, 21125 •. Commission amdadihvlhdptttbbrriarles �y MyComm.Espiresfeb12.2021orrt�A y?�� gp+dedthroug MGM NwgAsvL COUNTY F L 0 R I D R PLANNING & DEVELOPMENT SERVICES BUILDING & ZONING DIVISION 2300 VIRGMIA AVE FORT PIERCE, FL 34982 (772) 462-1553 FAX 462-1578 CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMT PLEASE SEL OF THE FOLLOWIN : 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. X 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: 218/2021 Site Address: 9563 S. Ocean Drive, Jensen Beach 34957 Permit Number: 2010-0267 L&W Roof Systems, Inc. State License CCC1327127 SLC License 16087 Original GC, subcontractor or owner/builder JA. Taylor Roofing, Inc. State License CCC1325720 SLC License 23018 New GC, subcontractor` Reason for Cancellation The undersigned does hereby agree to indemnify and gold 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/sub ontractor or cancellation of permit. A permit cannot be cancelled if work has been performed. Ate, �_ X./ SIGNATURE OF OWNER (or owner/builder) SIGNATURE [GENERAL CONTRACTOR (or new GC, as applicable) L PRINT NAME Vie. �k�� .� PRINTNAME. �1� �� I„t�1 T� State of Fknrida, County of State of Flotido, County of SC Lucie County The following ftmttummt was acknowledged before me this jt�dayof(��- 20o ,by }uk —wkso is pottunally known to me or who has as lA. Ic , 21=021 Signature of Notary date Revised 09/1 ........... % 10DI L PETERSON Iris Notary Public - State of Florida • •' Cornr lssion & GG 072290 MyComm. Expires Feb 12,2021 Mowing inauuneat was k dged before me this day of hl , 201 by� wbo is ttxsonoll�l ImowoMc to or who has produced m M. _5/'►�r�t i� J a„ A 6 A- 21812021 Signature of Mary o Date ;! &%.EY HEUF Cornmiss M Il HH 0793U * •a Q� �afnot' Expires Jam" 11, 2025 6did�dilwllugO�NohrrSrkrl PLANNING & DEVELOPMENT SERVICES BUILDING & ZONING DIVISION COUNTY 2300 VIRGINIA AVE FORT PIERCE, FL 34982 (772) 462-1553 FAX 462-1578 CHANGE OF CONTRACTOR, SUBCOIN'TRACTOR OR CANCELLATION OF PERMT PLEASE SELF ONE OF THE F LLOWIN : 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 S2,500 ($7,500 if A/C Change -out). A recorded copy must be submitted prior to commencing any work There is a S50.00 fee for the Change of Contractor. X 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 S50.00 fee for the Change of Sub - Contractor. CANCELLATION OF PERNIIT — 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 permlL Date: 202021 Site Address: 9563 S. Ocean Drive, Jensen Beach 34957 Permit Number: 2010-0271 LaW Roof systems, Inc. State License CCC1327127 SLC License 16087 Original GC, subcontractor or owner/builder JA Taylor Roofing, Inc. State License CCC1325720 SLC License 23018 New GC, subcontractor Reason for Cancellation 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 contractorlsubcontractor or cancellation of permit. A permit cannot be cancelled if work has been performed. SIGNATURE OF OWNER (or owner/budder) SIGNATURE GENERAL CONTRACCOR (or new GC, as Whceble) PRINT NAME h 'r r _ „ PRINT NAME .N lg_ - - - Lv�. State of Flmida, County of St4.ww*4Q rely State of Florida, County of SL Lucie County Till following instrm uent was acknowledged before ne this " day of • . 20L-;-�, hy�, i>> who is msonal1v known to me ar who has - �-�5`;rt__ Z1812021 Signature of Notary pate e following instrttmmt was acknowledged before me thi day of 3— 20a by J'�il W 1. who is ptnonally mown to or who has produced as 11) 2l812421 Signature o otaty Date Revised U4/1 16„, � p ` tODI L PETEASOH ASHLEY HEUER , .. =, NotaryPublic- StateofFlorida Commissiont00072280 * * A Co NnionIHH079398 EwiresJanwrytt,2025 V. s°+•` '�ocsta•' My Comm. Expires Feb i2,2021 fimdedthraughNab" Wary Aim pr -'>Ow � 9X"ThrueudgMNatarysar,k,� PLANNING & DEVELOPMENT SERVICES � I ` BUILDING & ZONING DIVISION • 2300 VIRGINIA AVE FORT PIERCE, FL 34982 (772) 462-1553 FAX 462-1578 CHANGE OF CONTRACTOB, 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 S2,500 ($7,500 if A/C Change -out). A recorded copy trust be submitted prior to commencing any work. There is a $50.00 fee for the Change of Contractor. X CHANGE OF SUBCONTRACTOR — Subcontractor changes are to be completed by the general contractor. The new subcontractor must Fill out a Subcontractor Agreement Form. There is a S50.00 fee for the Change of Sub - Contractor. CANCELLATION OF PERMT — The cancellation of a permit is acceptable only if no work has been done. Cancellation of permit is to be signed and notarized by both the owner and qualifier of record. There is no fee for cancellation of the permit. Date: 2IM021 Permit Number: 2010-0274 Site Address: 9563 S. Ocean Drive, Jensen Beach 34957 L&W Roof Systems, Inc. State License CCC1327127 SLC License 16087 Original GC, subcontractor or owner/builder JA. Taylor Roofing, Inc. State License CCC1325720 SLC License 23018 New GC, subcontractor Reason for Cancellation The undersigned does hereby agree to indemnify and hold harmless St Lucie County, its officers, agents and employees from all costs, fees or datnagm arising from any and all claims of action for any reason, which may arise as a result of this change of contractor/ bcontractor or cancellation of permit. A permit cannot be cancelled if work has been performed. 7ZO7 SIGNATURE OF OWNER (or owner/builder) SIGNATt1RE GENERAL CONTRACTOR (or new GC, as appficabk) PRINT NAME aril. L_ PM-rNAME. 1 State of Florida, County of i State of Ilorida, County oCSL Lucie Caun The following inMnleat was acknowledged before me tin of hY da • C-�-� . Ztby � r k who is R5M"1Y known to me Or who has p[M44ced as ID. Sigaaturs of Notary Date ty Revised 04/ Y JODILPETERSON t►F�r ASFELEYiiEIIER Msa try Public - StateofFlorida:. ryAt ,M?Cwr.m.ExpiresFeb12,2021 ,..° W5-d4",=0NjowlNouryAS$& flartdRia�YY,tNol1.2MoM C6UNTY F L „D-R l . D, A PLANNING & DEVELOPMENT SERVICES BUILDING & ZONING DIVISION 2300 VIRGINIA AVE FORT PIERCE, FL 34982 (772) 462-1553 FAX 462-1578 CHANGE OF CONTRACTO& SUBCONTRACTOR OR CANCELLATION OF PERMT PLEASE SELECT ONE OF THE F LL 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. X 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: 202021 Site Address: 9563 S. Ocean Drive, Jensen Beach 34957 Permit Number: 20ID-0277 LaW Roof systems, Inc. State License CCC1327127 SLC License 16087 Original GC, subcontractor or owner/builder JA Taylor Roofing, Inc. State License CCC1326720 SLC License 230113 New GC, subcontractor Reason for Cancellation The undersigned loss 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/subco or or cancellation of permit. A permit cannot be cancelled If work has been performed. SIGNATURE OF OWNER (or ownerlbuilder) SIGNATURE GENERAL CONTRACTOR (or new GC, as applicable) PRINT NAME LC:' PRINTNAME State of Florida, Count}�e `` State of Florida, County of St Lucie County The following iasnumau was aclmowiodged before me this _Pday of VZ12 2aL byes t who is Pers®ally (mown to me or who has produced_. 40L as 11) 2/a12021 — Signature of Notary Date following instrument was aeimmkdged before me this day of (tb0j0q, 200,, by ,who is Retaonall own to _ MW who W produced as ID. ah" -*LUL.�= 2/=021 Signature igNotary Date Revised 04/1KM 01LPETERSON blic - State of F orida V P ASHM HEUER ission a GG 072280 Expires Feb 12,1021oughN�lionalNeGryAssn�?elltt� , COMM14" s HN 0103A8. iiadslrlsatbdpMltMsgrNtrkaa _ PLANNING & DEVELOPMENT SERVICES C M J r TY BUILDING & ZONING DiVMSION F • 2300 VIRGINIA AVE FORT PIERCE, FL 34982 (772) 462-1553 FAX 462-1578 CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMT PLEASE SELECTOF THE FOE —LOWING: 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. X 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 pemtit 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: 218/2021 Permit Number: 20IM279 Site Address: 9563 S. Ocean Drive, Jensen Beach 34957 LrtW Roof Systems, Inc, State License CCC1327127 SLC License 16087 Original GC, subcontractor or owner/builder J.A. Taylor Roofing, Ina State License CCC1325720 SLC License 23018 New GC, subcontractor Reason for Cancellation 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/ bcontractor or cancellation of permit. A permit cannot be cancelled if work has been performed. 7Z `K111 SIGNATURE OF OWNER (or owner/builder) SIGNATURE GENERAL CONTRACTOR (ornew GC, as applicable) PRINT NAME ' 1� .x PRINTNA&M KVCL Y2D1 k State of Florida, County osy State of Florida, County of St. Lucie County The following iast,ument was acknowledged befotn the this -_day of 2d±t, by- __ .. _who is petromuyknown to who has Dmduced as ID. � - 2relzazl ■titre of Notary Date % following hulti meat was aelmowiedged bofotn me who is who has produced_ e_as a). 2/8/2021 Signstwre a otsty Date Revised 04/15/ ry,� ,•`4�i;,'p' .: JODII-PETERSON ap "•azfi ASHLEYHELM Notary Public -State d Florida i „ Conttttls 0 NH 079W Commission t GG 072288 +r J 11 ' y M Camm. Expires Feb 12, 2021 yam' flooded th.4 N.tioaal NalryAsrt W fL Pa'dM Aar �r4TMNetalrtiat