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HomeMy WebLinkAboutCHANGE OF CONTRACTORPLANNING & DEVELOPMENT SERVICES BUILDING ZONING DIVISION 2300 VIRGINIA AVE FORT PIERCE, FL .34982 (772) 462-1553 FAX 462-1578 CHANGE OF CONTkNCTOR SUBCONTRACTOR OR CANCELLATION OF PERT PLEASE SELECT' .0NE OF THE FOLLtIWrNCi: CHAINGF OF CONTRACTOR — Change of Contractor is to be signed and notarized by the pro ezx a�°ner, and the new contractor of record for the current permit. A new permit application must also be compleied with neuv 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 (5.7�500 if AIC Change -out). A recorded copy must be submitted prior to conimencing any worli. There is a $50.00 fee for the Change of Contractor. CHA�INGE OF UBCOINTR,A►CTOR— Subcontuctor changes are to be completed by the general contractor. The new subcontractor must fill out a Stibcontractor Agreement Fonn. There is a 550.00 fee for the Change of Sub- Coutractor•_ _ CANCELLAtTION OF PERIVHT — The cancellation of a permit is acceptable only if no work has been done. Cancellation of permit is to be signed and notarized by both the oNviier and qualifier of record. Therms is no fee for cancellation of the permit_ Date: Permit Number Site Address: `7 �1(�� �.��t®rN Wkes )> Q.k -1J �.. 3U& ;Z10'? - oc>9 (jp PSC' �.. T. � . *. State License ;;0-S8© SLC license Or`iganal �, stibcontractnr or ownerlbuilder State License c- 40AJ LC License «00 New GC. subcon"ctor Reason forCwicellation The undersigned noes hereby agree to indeniiiify and hold harn7tess St LIcel Cott zt , its o h -ers, agent and employees from aft costs, fees or datxxages arising from any and ait claims of action for airy rtr, lwj�dticw ise as a re t of this Change of ,contract bcontrnactor or cancellation of permit_ A perrnit cannot be r is eeu rMed, SIGRATURR 0t o _ tom_ ovaieri'btiiidex; € I+A [ J cr R mot{ roc; as appltc able) pIR?T 27? [S �i_wWPtii>r1�tA'ti�I� ; °' �Gir State of Florida_ Coulft- of St, Luo;e County Slate of Florida, Couniv of St. D;mt- County The following instrument eras ad mviedsed b a UW. IN$ The folicawv n n adlmolliedoe beto rm tNs day of 2tfp�� .bs 4_ day of _: by'.....�`--- �.•��M jyi l�tosi to a e d C$ L l iciu3 is p lmokim to vtam! d RYLvATp ���i/� rise z3sce ins Prod ed_ y1�1? Sr ro hascfff�llf i • ea(� Si�xataax-eof 2 ��`� r)a8r �� S�gxxmtutre of ti a I *' Aw'� =* #JGG 90E681 ♦C :Neal rtevisedi.4/x51t O�'�: 9 �'' Q '"": 41blic d 1ffi8eryy�� ti.jO :%:%i /l!!!llily1111� STAMO S1ua W,'��