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HomeMy WebLinkAboutChange of ContractorF Planning & Development Services Building & Code Regulations Division 2300 Virginia Ave. RECEIVED Fort Pierce, FL 34982 (772)462-1553 Fax 462-1578 ��� ®� 2021' permitting Department CHANGE OF CONTRACTOR St. Lucie County Or Subcontractor or Cancellation of Permit Change of Contractor is to be completed by the property owner, md-he new contractor of record for the current permit. A new permit application must also be completed with new contractor information, signature, and transfer fee. A new Notice of Commencement must be filed in the new contractor's name for job values greater than $2,500 ($7,500 if A/C Change -out). A recorded copy must be submitted prior to commencing any work. Subcontractor changes can be completed by the general contractor. Absent extenuating circumstances, a cancellation of permit is to be executed by both the owner and qualifier of record. Date: Jy-� rl 1 2—C> ( Permit Number: ©� a ^ Site Address:�� Zoovr�l`��� i TrQC 16 C" StT, U C hyN-,N State License SLC License Original General Contractor (or Subcontractor) GO RewuwState License Cie. 13:�ALO$LC License New General Contractor (or Subcontractor) Reason for Change 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 (e cancelled if work has been performSd—1 SIGI fTURE OF OWNER (or owner?bluilder)\ * SIGNATURE OF.MW GENERAL CONTRACTOR PRINT NAME 1 1LULP TNAME�U�cQ C (/�L,AAMgC7 State of Florida, County of St. Lucie County State of Florida, County of St. Lucie County The following instrument was acknowledged before me this/ The following instrument was acknowledged before me this /< day of :LMn , 2W byD en,, A'j`!aM1 day of Tu•'t 20Z, b)N JA4� who is ersonally know to me VZAF! e ar a+b or wh as producedas ID. ignature of tary re Date �,,.�f/ �gn of Notary ate a-� -�►� J Only si ature required for change of subcontractor F-1-nonded KARINAJ.ARROYO ry Public - State ofFlorida Revised 07/21/14 ommission # HH 019674 omm. Expires Jul 9, 2024 rough National Notary ass r. no�nws�ynlww► ,� �' . 3�eab�3wvraatissatlond�o �: 1511VO OE`NH111N 03tlG103_ U35N9JIlr1N3K3�Cld3tl,. � v�,°? Ct 'sQ114o0'9Z>tlM11Ja41w you RP�W��kRI 3,=SStll�� �' }i'p , kxG oaor�wrso '.' . bu., I vgaay 6uI LE Elm, . � t /alatbid , i 1I IR sweat I11I1II apuo���o 0 pY'