HomeMy WebLinkAboutConstruction Plans S��n
PLANNING & DEVELOPMENT SERVICES
- - BUILDING & ZONING DIVISION
• 2300 VIRGINIA AVE
a — 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-
C ELLATION OF PERMIT—The cancellation of a permit is acceptable only if no work has been done.
�,� Ion 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: ILy � 2O2/ Permit Number:
Site Address:Ail
State License SLC License
Original G subcontractor or owner/builder
State License SLC License
New GC,_ u contractor
Reason for Cancellation
The undersigned does hereby agree to indemnify and hold harmless St Lucie County,its officers,agents and employees p yees 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
L—suhcmILacto,r or cancellation of permit.A permit cannot be cancelled if work has been performed.
SIGNATURE OF OWNER(or owner/builder) SIGNATURE GENERAL CONTRACTOR(or new GC,as applicable) J
n
PRINT NAME PRINT NAME�� ��,�}[�
State of Florida,County of St.Lucie County State of Florida,County of St.Lucie County
The following instrument was acknowledged before me this^ n - The following instrument was acknowledged before me this
,Agay of 1�
„ � by (tM l Jam/ day of 20_,by
who is personally known to me who is personally known to
or w produced /Vas ID. me or who has produced as ID.
Signature of Notary Date . E LLI N VA U G H N Signature of Notary Date
i t,%�State of Florida-Notary Public..}
,.= Commission # GG 27007�
.o0 My Commission Expires €�
Revised 04/15/16 Ootober 22. 202.2 �''j