HomeMy WebLinkAboutCHANGE OF CONTRACTOR- _ PLANNING & DEVELOPMENT SERVICES
COUNTY BUILDING & ZONING DIVISION
• R 1 2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578
__CHANGE OF CONTRACTOR — Change of Contractor is to be signed and notarized by the and the new contractor of record for the current permit. A new permit property owner,
application must also be completed with new
contractor information and signature. A new Notice of Commencemenmu
for job
mmvalues greater than $2,500 ($7,500 if A.iC Change t st be filed in the new contractor's name
-oul)- A recorded copy trust be submitted riot to
coencing any work. There is a $50.00 fee for the Change of Contractor. p
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 pen it 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: a
Permit Number: —�-- p r
Site Address:
t
�eG r f C _ _ �TState License-G0
Original GC, subcontractor ar ownerlbuilder � SLC License
New GC, subcontractState License
or.17,AIESLCLicense 345
Reason for Cancellation
The undersigned ones hereby agree to indemnify and hold harmless St Lucie County, its officers, agents and employees from a!
costs, fees or dantages arising from any and all claims of action for any reason, whtch may arise; as a result of this change of
contrac(or/subcontractor or cancellation of y ! permit, A permit cannot be cane-Oed if work has been performed.
SIGNATURE O} OWVER (nr ownerfioildcr) _
51GNA7Ui2� GENE [YIyTR
PRINT NAME I�ijs� G IorncwCC.asapphcnbef
PR1NTTv:1rNE ��rl`
State of F1txiM. County of Sr Lucie County
The following instrument wis acknowledmed heft rr me tht:
L2Y—dflor'
y 't). by --
W�[3 • . .- Nrn, who is peraoI'") known to Inc
or who has produced__- ^^ass tD.
Signature or Notary Date
1 4/433 yeublic State of Flo, tCe
Hannah E Moore
W COMMI ton HH C. t i nga,
yMr� Expires 07101rZo24
%010 of Honda. County of A Lueie County
Theme following ln% rurnent uas acknowledged before me this
yof J1'J4r-J1 . 20. by
Y1/1 h Wilk WmMtall mown to
Inc Of wiw has prodKed - as ID.
signature or \otary Dare
R
Or Notary Public State of F�rtdaHannah E MooreAAA (,,rnm:StuOn HH of7099
Expres )710JM24