HomeMy WebLinkAboutCancel Permit 7001 Lakeland Blvd10/4/21, 11:58 AM
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PLANNING & Dk,.VL1,0PMVN1'SERV1CF:S
WILDING & ZONING DIVISION
L401 WW I 1 2.100 VIRGINIA vVE
FUMTPIEWT, F1 - 34t)82
(772) 462-1553 VAX 462-1578
f- "A I-12-21-2f -.!! IR, St BC ON I RU ['OR OR ( ANCV1 I A I IQN OF Pj,,RNj,v
L'L IN(
____CU-8NC.F0FC0NTRACT0R ('han9v of'( Itsactof ',to he siuncdimd nt,tati/ed by the property owri,:r,
anif the ncNi, contij,jo, of n.-4,ord gin
0I dic cliticill rwilivit A nv%% permit application must .114(bccomplet,(I it h
11cvs
conrnieiov 111oril.ij,111 uaneI N1911at"re. A nc" Notwc of Cortirovocernent nivist be tiled in the new contractor ., narne
f4lf J(Ph %'-3hWN 91cMer than S2a5(110 Vs_?,-4)0 if A,( C A jet-orded copy rouq be submitted prior it,
coriuncrc)ng anN %A cith There is a S50-00 fee for the Change of ( ontractor.
____ ( 11ANG'f' OU NI'M "ONJ RA(A OR -- Subcomractot changes arc to be corriplztcd by the general .:ontractur
he new suK-ontractor mu, I ,, fill (nit it Subcontractor Agreement Form. There is a S50.00 fee for the Change of Sub -
Contractor.
C-IiNCELLATION OF PEILVUT - 111c cariccliation of a permit is acceptable only if no work has been done.
Cancellation of* perrrat IS to be signed and notarized by both the owner and qualifier of record. There is no fee for
cancellation of the permit.
J)ate: 6,129121
Permit Number, SLC 2010-0202
Site Address: C)C5 U,v f—'t CaC'\6 n 1"Vd
Cool Air Sofutiions of Monde, Inc. State License CAC1819009 SLC License
Original GC, subcontractor or ownerbuilder
License---- SLC License
-New GC, subcontractor
Raa,on ,-,)r (- 2ricellatior
Thu agree to indemnifv and hold harmless St Lucie County. its officers, agents and employees from all
costs. fees or damages ansing from any and all claims of action for any reason, which may arise as aresult of thischangeof
ion ol'perma A permit cannot be cancelled if work has been performed.
c�cln ractor/su zcontractw—(,�r 4�
510NAUT-IRE0F 01A`.NX-9 (of owner/builder)
JR(orncw GC, as applicable)
PR1VT NAM_VRINTNAMV _�Q
State of Florida, (-ounrf of St. Lucie County
llowing instrumcrit was acknowludgetl before me 11w,
{day of 20
who isLpermonal
has oroduced --*; 11)
M
�visetl )4/_5/.'
URVIS
FBIZIlEB
, '? '., $TATON MARO
Commission 4GG162017
Expires October 16,20218*35IS Swx"ThmTray Fain kwum
c,wc of Honda. County of St. Lucie County
In 1,01lowing InsilugictU was acknowledged before me this
.------_—_-who is personally known to
MO sir who bi-, produccd_ 144S, ID,
6/29/21 1010Y120Zf
I
Signature of Notary Dare
DADA HARRIS
State of Florida
NOTARY Commission: HH 89947
E-Apites: 02/08/2025
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