HomeMy WebLinkAboutPermit Cancellation.pdfPLANNING & 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 FOLLOWENG:
CHANGE OF CONTRACTOR - Change of Contractor is to be signed and notarized by the property owner,
and the new contractor ofrecord for the cun.ent pemit. A new pemit application must also be completed with new
COntraCtOr infomation and signature. A new Notice of Commencement must be filed in血e 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
COrrmenCmg 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 co血actor.
The new subcontractor must fi11 out a Subcontractor Agreement Form. There is a $50・00 fee for the Change of Sub-
CANCELLATION OF PERMIT - The cancellation of a pemit is acceptable only ifno work has been done.
Cance=ation of pemit is to be slgned and notarized by both the owner and qua睡er of record. There is no fee for
CanCellation of the permit.
Date:p。.mitNumb。.: /グ∂年@多/1
si,。Addr。§S:約t7ろ D亮ルイAL& ,存秋定
。‡艶盈純毛藍肋 StateLueuse雌LCLICenSe
State License SLC License
R。aS。nf。r。an。。Ilati。n ▲偽 れ。存 初リ 4/e
The undersigned does hereby agree to indemnfty and hold hamless St Lucie County, its o飾cers, agentS and employees from all
COStS, fees or damages arislng from any and all claims ofaction for any reason, Which
COntraCtOr/subcontractor or cancellation ofpemit. A permit cannot be ca
SIGNATURE OF OWNER (Or OWner化uilder)
PRェN冒 NAM巳
may arise as a result ofthis change of
WOrk has been performed.
ONTRACTOR (Or neW GC, aS aPPlicable)
Leyva Plumbing Services, Inc"
1502 SW MERIDIAN AVE., Port St. Lucie, FL 34953
Tel/: 772-871-5893 Fax 772-672-3673
Lic, No. CFC 1425666
Leyvaplumbing@yahoo. com
RE: Building Permit number 1909-0214
」ob: 8403 Deiand Ave. Fort Pierce
与/26/2021
To the buiIding o冊cia=n regards to the permit iisted above. Water heater
insta=ation. There was a permit pu=ed but no work was started there. The home
OWnerdecided to move on with the se= ofthe home and not perform the work,
Leaving the work for someone eIse to do ifthey wanted to.
Leyva plumbing did not perform any work or any insta=ations in this property.
I wouId Iike to remove the permitfrom myfiles, PIease.
Anyquestions piease emaii me orcaII myceIl number.
Abner Leyva
Service
512712021