Loading...
HomeMy WebLinkAboutCHANGE OF CONTRACTORPLANNING & 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: �1 �� �,y 7T— Permit Number: C-;L1 Z a©Q Site Address: n '�� �� Ilff F' 1 A State License SLC License Original GC, subcontractor or ownerlbuilder Pf� q ? Q� Gl A f� go3 E � YvJ State License C C CI �3i��P �1C License � � New GC, subcontractor Reason for Cancellation 1 � 0-5 (J 1 The undersigned does hereby agree to indemnify and hold harmless St cie County costs, fees or damages arising from any and all claims of action for whic contractor/ bco tractor or cancellation of permit. A permit cann,Vea, Iled Lj.j. 2 its officers, agents and employees from all may awe ps a result of this change of work h° s.beeaerformed. SIGNATURE OF OWNER (or owner/builder) NATURE CO -,TORCor new GC as applicable) XPRINT NAME/ / �l Sh n PRINTNANMA4 (J �/ State of Florida, County of St. Lucie County The following instrument was acknowledged before me this D day of /vs,VemJ e/20-all by dab, i &Lg k who is personally known to me or as prod eyc d as ID. Igoe ure of Notary Date l / r/a., State of Florida, County of St. Lucie County The following instrument was ackmowledg efore me this / day, of A-10 e✓7L-6e/10a-1 by �, // ( 1' ill S who is personally known to me or who has produced as ID. S�ature of Notary bate Notary Date / o��Rr auet� FAITH MASON SPRY PUB Revised 04/15/16 * * Commission # GG 960757 20.,...,.�,� FAITH MASON N9TFpp F`O�\QQ• Expires BnndedTluu Budget Notary SSeMces 9 oe CExpires lJu e20, 2024 7 Bonded Thru Budget Notary Services