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Home My WebLink AboutChange of Subcontractor- Roofing Bldgs A-FPLANNING & DEVELOPMENT SERVICES { BUILDING & ZONING DIVISION 2300 VIRGINIA AVE FORT PIERCE, FL 34982 (772) 462-1553 FAX 462-1578 CHANGE OF CONTRACTOL SUBCONTRACTOR OR CANCELLATION OF PERMT PLEASE SELECT ONE OF THE F L G: 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. X 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 $50.00 fee for the Change of Sub - Contractor. CANCELLATION OF PERMIT — The cancellation of a permit is acceptable only if no work has been done. Cancellation of permit is to be signed and notarized by both the owner and qualifier of record. There is no fee for cancellation of the permit. Date: 2IW2021 Permit Number: 2010-0252 Site Address: 9563 S. Ocean Drive, Jensen Beach 34957 L&W Roof Systsms, Inc. State License CCC1327127 16087 SLC License Original GC, subcontractor or owner/builder J.A. Taylor Roofing, Inc. State License CCC1325720 SLC License 23018 New GC, subcontractor Reason for Cancellation The undersigned does hereby agree to indemnify and hold harmless St Lucie County, its officers, agents and employees from all costs, fees or damages arising from any and all claims of action for any reason, which may arise as a result of this change of contractor/subcontractor or cancellation of permit. A permit cannot be cancelled If work has been performed. SIGNATURE OF oSV11NER (or o fw'ne^r/builder) SIGNATURE GENERAL CONTRACTOR (or new GC, as applicable) PRINT NAME �IeJe.� PRINfNAME State of iZ ends, County of Su uoiaCouatY State of Fkaida, County of St Lucie County �e touowiug instrument was wlmowkdvd fore me this day of 24y by [�` is tnLu�kno!T_to me or who produce�_ss ID. 2WO21 Signature of Notary Date fbilovvmg instrument was whwwladgM before me;his dayof4 20$S, by_K tay'Itlo who is o �Stt who has produced as M. 2Ia12021 Signature a ot"y Date Revised 0 ASHLEY HEM JODI LPETERSON ••�•' 'Y ,„ Notary public -State of Florida �► * g HH 019©88 Commission s GG tJ722tA " E9irn Jawry11, 2125 :�y My Comm.UpiresFeb12.2021 4orrt�A 6cnd.ethv8rdpattlohrtia,l� y?� �" ' gp+ded through MGM Noury AsvL DRUM COUNTY F L O R I D R PLANNING & DEVELOPMENT SERVICES BUILDING & ZONING DIVISION 2300 VIRGMIA AVE FORT PIERCE, FL 34982 (772) 462-1553 FAX 462-1578 CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMT PLEASE SEL OF THE FOLLOWIN : 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. X 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: 218/2021 Site Address: 9563 S. Ocean Drive, Jensen Beach 34957 Permit Number: 2010-0267 L&W Roof Systems, Inc. State License CCC1327127 SLC License 16087 Original GC, subcontractor or owner/builder JA. Taylor Roofing, Inc. State License CCC1325720 SLC License 2301 a New GC, subcontractor Reason for Cancellation The undersigned does hereby agree to indemnify and hold harmless St Lucie County, its officers, agents and employees from all costs, fees or damages arising from any and all claims of action for any reason, which may arise as a result of this change of contractor/sub ontractor or cancellation of permit. A permit cannot be cancelled if work has been performed. Ate, �_ X./ SIGNATURE OF OWNER (or owner/builder) SIGNATURE [GENERAL CONTRACTOR (or new GC, as applicable) PRINT NAME�'�v7� PRINT NAME. J 1 ��l T� State of Florida, Crnmty of State of Fbtida, County of SL Luce County The following hm tummt was acknowledged before me this day of ��b. 20�k , by � _ N _ who is pw onally known to me or who baa as lA. ' 21=021 Signature of Notary date Revised 04/1 ........... % 10DI L PETERSON Iris Notary Public - State of Florida • •' Cornr lssion & GG 072290 MyComm. Expires Feb 12,2021 Mowing inauuneat was k dged before me this day of hl , 201 by� wbo is ttxsonoll�l Imown sa Mc or rw� n tus produreed m ID. _� 2ra12021 Signatare of W1.7 Date ;! &%.EY HEUF Cormals M Il HH 0793U * •a Q� �OfM1� Expires Jam" 11, 2025 add�dliwOudp�pohrrti�nkrl PLANNING & DEVELOPMENT SERVICES BUILDING & ZONING DIVISION 2300 VIRGINIA AVE FORT PIERCE, FL 34982 (772) 462-1553 FAX 462-1578 CHANGE OF CONTRACTOR, SUBCOIN'TRACTOR OR CANCELLATION OF PERMT PLEASE SELF ONE OF THE F LLOWIN : 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 S2,500 ($7,500 if A/C Change -out). A recorded copy must be submitted prior to commencing any work There is a S50.00 fee for the Change of Contractor. X 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 S50.00 fee for the Change of Sub - Contractor. CANCELLATION OF PERNIIT — 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 permlL Date: 202021 Site Address: 9563 S. Ocean Drive, Jensen Beach 34957 Permit Number: 2010-0271 LaW Roof systems, Inc. State License CCC1327127 SLC License 16087 Original GC, subcontractor or owner/builder ,lA Taylor Roofing, Inc. State License CCC1325720 SLC License 23018 New GC, subcontractor Reason for Cancellation The undersigned does hereby agree to indemnify and hold harmless St Lucie County, its officers, agents and employees from all costs, fees or damages arising from any and all claims of action for any reason, which may arise as a result of this change of contractorlsubcontractor or cancellation of permit. A permit cannot be cancelled if work has been performed. _ <1" ��_ el-111 SIGNATURE OF OWNER (or owner/budder) SIGNATURE GENERAL CONTRACCOR (or new GC, as Whcable) c", PRINT NAME � r a PRINT NAME .N lQ�s tt_ ''y,,�� State of Flmida, County of 5ra.uwtderety State of Florida, County of SL Lucie County Till following instrm uent was acknowledged before me this " day of • . 201�- L by, I'`llcm, who is pcooail imown to ma n or wbo has p �VZO�21� - Y �JC 1-tL '1 _,x Signature of Notary pate e following instrttmmt was acknowledged before me thi day of�� 20a byy�'�il W who is ptnsonally mown to or who has producod_ as ID. 2l812421 Signature o otary Date Revised U4/1 16„ tODI L PETEASON :� ASHLEY HEUER =, NotaryPublic- StateofFlorida Commission t GG 072280 * * A Co NnionIHH079398 Ewitess Janwryi t 2025 V.�FY.s •. My Comm. Expires Feb i2,2021 $ondedthr�ughNallonalNMaryAav+. pr -'4•pr�ow &X"ThrueudgMNataryr r PLANNING & DEVELOPMENT SERVICES COUNTY BUILDING & ZONING DIVISION 2300 VIRGINIA AVE FORT PIERCE, FL 34982 (772) 462-1553 FAX 462-1578 CHANGE OF CONTRACTOB, 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 S2,500 ($7,500 if A/C Change -out). A recorded copy trust be submitted prior to commencing any work. There is a $50.00 fee for the Change of Contractor. X 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 S50.00 fee for the Change of Sub - Contractor. CANCELLATION OF PERMT — 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: 2IM021 Permit Number: 2010-0274 Site Address: 9563 S. Ocean Drive, Jensen Beach 34957 L&W Roof Systems, Inc. State License CCC1327127 SLC License 16087 Original GC, subcontractor or owner/builder JA. Taylor Roofing, Inc State License CCC1325720 SLC License 23018 New GC, subcontractor Reason for Cancellation The undersigned does hereby agree to indemnify and hold harmIcss St Lucie County, its officers, agents and employees from all costs, fees or damagrs arising from any and all claims of action for arty reason, which may arise as a result of this change of contractor/ bcontractor or cancellation of permit. A permit cannot be canceued if work has been performed. SIGNATURE OF OWNER (or owner/builder) SIGNATURE GENERAL CONTRACTOR (or new C7C, u appficable) PRINT NAME. State of Florida, County of M[= State of Ilorida, County oCSL Lucie Caun The following inMnlevi was acknowledged before me tis h day of � . 26 1 _, by e� k l who is was malty known w me or who has i� as ID. � ZI812021 Slgaaturs of Notary Date rY Revised 04/ YkJODILPETERSON tMtyrus ASHLEYHEUER HoiigPuVic-Stateofflorida �' �•�••� Commi55 on a GG 0122110 • * COMMssba 2 HH OMM i • t ': F.xplrN Jaewt)r 11.202E MyCemm. Expires Feb 12, 2021 -, At Aohledih rough National Noury Assn. �lpf nog' flartd thv tkat�tNdrySaMoy COUNTY F L b R 1 1) A PLANNING & DEVELOPMENT SERVICES BUILDING & ZONING DIVISION 2300 VIRGINIA AVE FORT PIERCE, FL 34982 (772) 462-1553 FAX 462-1578 CHANGE OF CONTRACTO& SUBCONTRACTOR OR CANCELLATION OF PERMT PLEASE SELECT ONE OF THE F LL 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. X 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: 202021 Site Address: 9563 S. Ocean Drive, Jensen Beach 34957 Permit Number: 20ID-0277 LaW Roof systems, Inc. State License CCC1327127 SLC License 16087 Original GC, subcontractor or owner/builder JA Taylor Roofing, Inc. State License CCC1326720 SLC License 230111 New GC, subcontractor Reason for Cancellation The undersigned does hereby agree to indemnify and hold harmless St Lucie County, its officers, agents and employees from all costs, fees or damages arising from any and all claims of action for any reason, which may arise as a result of this change of contractor/subco or or cancellation of permit. A permit cannot be cancelled If work has been performed. Z—L— KJ SIGNATURE OF OWNER (or owner/builder) SIGNATURE GENERAL CONTRACTOR (or new GC, as applicable) PRINT NAME �� :�;. �— mwrNAmE State of Florida, Caunty___ ' State of Florida, County of St Lucie County The following iasnument was acknowledged before me this day of VZAr� 2W, by i t''t 'S' --who is personally (mown to me — or who has produced_. as ID. Signature of Notary Date following instrument was aeimmkdged befm me this day of (tbainq, 200,, by who is Reraondk own to _ MW who W produced as ID. ah" -*�� 2/=021 Signature igNotary Date 1O01LPETERSON otary Public - State of F orida Revised 04/1Ell- el P4 ASHM HEUER Commission a GG 072280 Comm. EsPires Feb 12,2021 '� + f'ndedlhroughNilionalNeiaryAsssi �i�ellt_ COMM14" s HN 0103A8y -01 tladrlrlaatatApMNsaatrNfMCa _ PLANNING & DEVELOPMENT SERVICES BUILDING & ZONING DIVISION F COUNTY 0 R I V fj 2300 VIRGINIA AVE FORT PIERCE, FL 34982 (772) 462-1553 FAX 462-1578 CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMT PLEASE SELECTOF THE FOE -LOWING: 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. X 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 pemtit 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: 218/2021 Permit Number: 20IM279 Site Address: 9563 S. Ocean Drive, Jensen Beach 34957 LrtW Roof Systems, Inc, State License CCC1327127 SLC License 16087 Original GC, subcontractor or owner/builder J.A. Taylor Roofing, Ina State License CCC1325720 SLC License 23018 New GC, subcontractor Reason for Cancellation The undersigned does hereby agree to indemnify and hold harmless St Lucie County, its officers, agents and employees from all costs, fees or damages arising from any and all claims of action for any reason, which may arise as a result of this change of contractor/ bcontractor or cancellation of permit. A permit cannot be cancelled if work has been performed. 7Z `K111 SIGNATURE OF OWNER (or owner/builder) SIGNATURE GENERAL CONTRACTOR (ornew GC, w applicable) PRINT NAME t�L + PRINTNA&M 1 State of Florida, County o{nty State of Florida, County of St. Lucie County The following instrument was acknowledged befotn the thin !ttdayt zo i b5+ �wha is petsosallylmowa to who haw uced as ID. yam` 218/2021 'Ap■titre of Notary Date Tk following tomMnent was w3mowledged befotn me )111 LK ._ who is == who has pmduccd,. .- _ _ w iD. 2/8/2021 8ignstwre a otsry Date Revised 04/15/ ry,� F�Bd,dth.4NAi..INiA1rYA%S1% JODILPETERSONASHLEYHEUEf{ry Public -State d Florida Conttttls 0 HH 079W mmissionitGG072280 J 11omm. Expires Feb 12,2021am' Pa'dM ilsr ��}.tNpfirsytMeM