HomeMy WebLinkAboutCANCELLATION OF PERMITPLANNING & 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.
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.
Date: 08/31/2021
Site Address: 8720 Bally Bunion Road Port Saint Lucie, FL 34986
Permit Number: 2107-0435
Climatic Solar Corporation State License CVC56671 SLC License
Original GC, subcontractor or owner/builder
New GC, subcontractor
License SLC License
Reason for Cancellation Customer cancelled contract. No work began at site.
The undersigned does hereby a re, to indemnify and hold harmless St Lucie County, its
costs, fees or damages arising o an and ims of action for any reason, which m;
contrac[or)u6con[rac^ tic e at� of tt A permit cannot bgWancelled if[ot
PRINT Name Erik F. DeLaney lJ�/
State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this
31 day of August
2021 , by
Erik F. DeLaney
who is personally known to me
w has produced
as ID.
V
08/31/2021
ignature o tary
Date
Revised 04/15/16
Halnigh Short
Notary Public
Vvec
SFloridate of Flori
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Comm#HH118473
is
expires 5/25/2D25
agents and employees from all
0i res�this change of
as applicable)
PRINT
State of Florida. County of St. Lucie County
The following instrument was acknowledged before me this
-3) dayof il2qticA ,2o71 by
Fn 1C F O WW n J who is personally known to
line r who has produced as ID.
ignatureo tary Date