HomeMy WebLinkAboutCHANGE OF CONTRACTOR (2)PLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 4624553 FAX 4624578
CHANGE OF CONTRACTOR SUBCONTRACTOR OR CANCELLATION OF PERMIT
PJS3ASE SELECT ONE OF TFJE FOLLOWING:
CI-I&NGE 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 will) 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
conmiencing 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.
DRte:
04/30/2021
Permit Number: 2006-0022
Site Address: 7467 GULLOTTI PLACE
ED' S ELECTRIC INC State License EC0001569 SLC License
Original GC, subcontractor or owner/builder
AAPEX ELECTRIC
State LicensoEC13009343 SLC License
New GC, subcontractor
Reason for Cancellation
The undersigned does hereby agree to indenudfy and hold harmless St Lucie County, its officers, agents and employees fiom all
costs, fees or damages arising from any and all claims of action for any reason, which may arise as R result of this change of
contractorhubcontractor or cancellation ofpermit• A permit cannot be cancelled ifiworipoltas,been performed.
MARK MONTA PAUL ROMANO���—_
SIGNATURE OF OWNS or aer/bl' SIGNATURE G CONTRACT,�(rt��(ornety (39, as applicable)
PR AMR PRINTNAME
Slate
of Florida, County of St. Lucia County
The following inshttment wns oclmmvledged before me this
day of Q 1 1 .20 0 L, hY�Cli_
!11Y� n-m �]'�_who is personally knotm to me
orw1uJuipproduced aaID,
Signdtii roof Notary mate y/3o11011
Stale of Florida, County of St. Lucie County
J��Jte allmving in mment wns aclotowlcdgcy�bafouro mo this
day of �PR.I L. ,2o�,by
2 l.A /� wh Is paso� wvn�to
��or tvho has prodOr,.Gns ID.
yillM�c R�UcrUr�� 0 Z?J Z!
Slgnnha•e of Notary Date
Revraed 04/15/1G v,o
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Notary Public Stele d Elands
Fullwood
My Commission HH 054534
Exp�rea 10/taY2021
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