HomeMy WebLinkAboutChange of SubContractor, Electric- - 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,
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.
X 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 PERNUT — 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:
Site Address: _ 5—te } L SLP
G & G Electric, INC
Original GC, subcontractor or owner/builder
New GC, su contractor
Reason for Cancellation_
Permit Number:
_State License EC13002278 SLC License 13727
.State License_ License
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 of permit. A permit cannot be cancelled if work has been performed.
S1GNA'fURts WNER (or owner/builtier) ic2ibxRE (36 A CONTRACTOR (or new GC, ii applicable)
PRINT NAME S PRINT NAME -�-1
State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this
_ day of 20�, by
,� _who is personally known to me
or ho has produc d_ as ID
Signature of Notary Date
�.*«' Notaiy rubric state a Ft«wa
Rev {annail E Moore
�a My 'o1n1nissron HH 0170g9
. xp,fes D 7fp 1 r2024
State of Florida, County of St Lucie County
The following instrument was ackn wledged before me this
day Of 2 ,by
r{ _who is personally known to
me r who has produce _._. _as ID.
Signature of Notary Date
allotary Public State of Flprrda
Hannah E Moore
My Commmsion HH 017099
Expires 07/0112024