HomeMy WebLinkAboutMisc Letters PLANNING & DEVELOPMENT SEf*
BUILDING & ZONING DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982 MAR-,O 8 2021
(772) 462-1553 FAX 462-1578 Permitting [department
St. Lucie County, FL
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-
Contra tor.
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: Permit Number:
Site Address: f�f A 7-7G4-:-S 3LJ 72)
State License SLC License
Original GC,subcontractor or owner/builder
State License SLC License
New GC,subcontractor
Reason for Cancellation A)m-J
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 Zpeit.A permit cannot be •a Celle if work ha ben perform d
SIGNATURE OF OWNER(or owner/builder) SIG TURF GENERAL COONNTRACTO r new GC,as applicable)
PRINT NAME PRINTNAME A1l C11*P L/Z
State of Florida,County of St.Lucie County State of Florida,County of St.Lucie County
The following instrument was acknowledged before me this Ule following�' ent was acknowledged before me this
D,���,,-'1 Z-da of {f C6 20 ��� �/� /?
_day of Y OIIr' 20 ZI ,bYJ�1L)dd.L� y �by-���1-�'�e�•(s�uF���iG•
Mad -e p d who is persona known to me who' ersonally known o
or wh has produ as . me as ID.
t72- l-71Zi — �� ��
Signature of Notary ate Ry p Signature of Notary Date
Revised 04/15/16 : ALISON CUNNINGHAM ;•1�!"f:: : asERrM.coRso
'•. Notary Public,State of Ohio MY COMMISSION HH 036663
My Commission Expires ,, �" EXPIRES:August 26.2024
sT0 May 3,2021 Bonded Thru Notary Public Undenrtilers
"4TE OF'p�
February 17,2021
Treasure Coast Barge Inc.
1200 SE Dixie Cutoff Rd
Stuart, FL 34994
RE: Permit#2011-0548 MacLeod 43 Nettles Blvd Jensen Beach, FI 34957
Dear Sir:
Enclosed is a Change of Contractor,Subcontractor or Cancellation of'Permit form regarding permit
#2011-0548.
I have completed the Owner's portion of the form.
Would you please complete the Contractor's portion of the form and send it in the enclosed,stamped
envelope to St Lucie Co Building and Zoning Division?
Thank you,
Sincerely,
Donald F MacLeod
4484 Woodland Dr
Mason,OH 45040
513 478-6365
Dmacleod4484@yahoo.com
t,
Lucie `1l i�r;l
REC.
MA�.�8 2021
fitting Department
perm County► FL
Ste Lucie