HomeMy WebLinkAboutvoid letterPLANNING & 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.
fc`ua 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: 2)212022 Permit Number: 2201-0218
Site Address: 30 CALLE DE LAGOS
WYNNE BUILDING CORP.
Original GC, subcontractor or owner/builder
New GC, subcontractor
License SLC License 8898
License SLC
Reason for Cancellation WILL BE BUILDING A DIFFERENT MODEL ON THIS LOT
The undersigned does hereby agree to indemnify and hold harmless St Lucie County, its officers, agents and employees from all
costs, fees or damages ansil g,from any and all claims of action for any reason, which ma as a result of this change of
contractor/su or c—auladlilion Of permit. A permit cannot be cancell r t has b rmed.
SIGNATURE OF OWNER (or owner/builder) SIGNATURE GENERAL CONTRACTOR (or new GC, as applicable)
PRINT NAME MATTHEW LYLE WYNNE PRINTNAME MATTHEW LYLE WYNNE
State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this
_,2_dayof�, 20,"by WTiNEWLVLEVNNE
X who is personally known to me
or who has produced as ID.
,qq ho has .y 2/2022
Signature otary Date
iil °'-"moo. DOROTHYANN BASY,IN
Revised 04/15/1 s MY COMMISSION # HH 045443
EXPIRES: October 2,2024
horded Thm Notary Public Undenvrilers
State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this
_J.—day of�, 20,2Aby a"--L1---
X who is personally known to
me or whop has produced as 1D.
L, j y (�,.y 0, ,(�,o 2f212022
Signature df Notary Date
DOROTHYANN BASKIN
MY COMMISSION#HH 045443
EXPIRES: October2, 2024
Bonded Thm N otary Public Underwriters