HomeMy WebLinkAboutChange of Contractor _ 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,
d the new contractor of record for the current P P
permit. A new ermit application must also be completed with new
P
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:
y��1 a.� Permit Number: �» d
Site Address:
(� �I ec-4 U c� State License SLC License
Original GC,subcontractor or owner/builder
��-rrti C� 014�P W5 ec State License �Z LC License
New GC,subcontractor f ,l
Reason for Cancellation OM 1`y`a %x�-�`F ae_45 lr Y1(SK3 1--tr S
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
contract /subcontractor or ca llation of permit.A permit cannot be c Iled if r s n performed.
SIG A OF OWNER(or o fwn�er/builder) SIGNATURM j WIERVI,CONTRACTOR(or new GC,as applicable)
PRINT NAME Sicuc Wb`��e✓s PRINT NAME �MY t4
State of Florida,County of St.Lucie County State of Florida,County of St.Lucie County
The following instrument was acknowledged before me this ollowing i ent ack wled e e this
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Si nature of Nota Date Signature of;►\ ON •' //
rv�•., DEANNA GIVENS �'cP O'�Os�il+
Notary Public•State of Florida *?
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My Comm.Expires Jan 28,2025 * • {i{0OB693
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