HomeMy WebLinkAboutChange of contractorPLANNING & DEVEL®PP':ENT SERVICES
BUILDING & ZONING DIVISION
-
2300 VIRGINIA AVE
FORS' FIERCE, FL 34982
(772) 462-1553 FAX 462-1578
CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF P ElRMT
PLEA SESELECT ONE OF THE FOLLOWING:
t/ CHANGE OF CONTRACTOR — Change of Contractor is to be signed and notarized by the propc.rl %
and the new contractor of record for the current permit. A new permit arolication must also be completed %,N i?!
contractor information and signature. A new Notice of Commencement inust be fled in the new contractor'-.
for job values greater than $2,500 ($7,500 if A/C Change -out). A .ecorded copy must be subl.3itted ;
commencing any worts. There is a $50.00 fee for the Change of Contractor.
CHANGE OF SUBCONTRACTOR -- Subcontractor changes are to be completed by the general conir:i,
The new subcontractor must fill out a Subcontractor Agreement Form. There is a $50.00 fee for the Change of :;u.
Contractor.
CANCELLATION OF PERMIT — The cancellation of a permit is acceptable only if no work has hevo
Cancellation of permit is to be signed and notarized by both the owner and qualifier of record. There is inr, I'<
cancellation of the permit.
Date: i� �� 2 Permit lumber: 2107-0701
Site Address: C� C ) -Z
Arturo Reynoso - doing Roofing, Co. State License CC *1332511 SLC License 32144
__
Original GC, subcontractor or owner/builder
on^
rC t�IState License�L"\-Z-' anse
New GC, sub ontractor
Reason for Cancellation
The undersigned does hereby agree to indemnify and hold harmless St Lucie County, its officers, agents and empl �yees fmtii
costs, fees or damages arising from any and all claims of action for any reason, which may arise as a result of this cltangc v.'
contractor/subcontractor or cancellation of permit. A permit cannot buq cancelled if work has been performed.
S�ttA MR8 OF OWMR (or oivner/builder) 51GNKl'Ukl��RAOR (o Wy GC, as appt,c•allip
PRINT NAME f'/ �3`�'' '`� ����I PRINTNAM1LV__A___V
State o1'Flarida. County ot•Sl. Lucie County
fl% following idstrumegi waspcknowledged b6or rnc'his
_day oft ( r_ AA, by 1 1 9 I
who is pe
rsonally known to me
.'nruhahasprod red
Snnlure ot'7Vota ' Date r
a
''^•. RANIELLE B. JEWFL�Revised 09/15/16 €NotaryPubllt-State alF[midaCommiss[an A GG 937394
"�s My Comm. Expires Qec 5, 2oZ3pq=-
Slate of Florida. Cou i.yofSt. Luciycounty
1heFt1illowinginstrunignI. was ackn�wkdged,l�� n It
day orSr?—_ .30_ b . t'I� —�
who is pcmanally knotirn to /
mWorica praducud Fi- 1)L- us lt}
:�ignmure of molars Date
P!cn
, AMBER LSHIRK
Notary Public- State of Florida
Commission # GG 243270�• My Comm, Expires Oct 23, 2022
onded through National Notary Assn.
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