HomeMy WebLinkAbout Cancellation of Permitwim
PLANNING & DEVELOPMENT SERVICES'
BUILDING & ZONING DIVISIOi
2300 VIRGINIA AVE
FORT PIERCE, FI L 34982-
(772) 4624553 FAX 4624578
URANCE Of CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERW
PLEASE SELECT ONE OF't73E FOLLOV✓IldCr'
CHANGE OF CONTRACT OR Clrange of Contractor is to be signed and notarized by the property owner,
and tlrC new contractor oftecprd for the current permit, A new permit application must also be completed with new
contractor information and signature. A new Notice of Commencement laust be filed in the new colit ractor's name
for job values greater than $2,500 ($73500 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.
( ANCELLATYON OF PIERM[T The cancellation of a permit is acceptable only if no work has-been done.
Lance lotion 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 February 17, 2029 LPermit Number* SLc2Tat oti5s
St te Address. g10l� Y'r Ck��>�i �'+ (1Ct'2
Christopher Shaw,.FPL Home Services 5'tate T.irxnca EC13009228 Qt 0 T ::.e„.,...
State i.iconse SLC I.heense
New G�; subcontractor
Reason for Cancellation Meter was damaged and FPL was called cut and they installed new S00A meter
The undersigned does lereby agree to mdenmrfy and hold harmless St Lucie County, its of ctis, 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
cOnnnactn�r/subbeentra_ckif or cancellation ofpermit. A..permit cannot h cancelled -frwork ha been performed.
OL '/ Qg j Y
SIGNh't1iREOF QWN (ot ownerPouilder). SIGNATURE GENERAL CQ�PTRACTOR(urnetvGC, as Wppllcatle)
PRINT nAmLE Akos 8 Dehneky FRINTNAME Christopher Shaw
State ufFiovida, County ofSt, Lucie County State afFlorida, County 'or5t Lucie County