HomeMy WebLinkAboutcancellation noticePlanning & Development Services
Building & Code Regulations Division
2300 Virginia Ave.
Fort Pierce, FL 34982
(772)462-1553 Fax 462-1578
CHANGE OF CONTRACTOR
Or Subcontractor or Cancellation of Permit
Change of Contractor is to be completed 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,
signature, and transfer fee. 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. Subcontractor changes can be completed by the general.
contractor. Absent extenuating circumstances, a cancellation of permit is to be executed by both the
owner and qualifier of record.
Date: 02/02/2022
Site Address: 6002 INDRIO RD K- �,
Permit Number.- 2110-0049
&-i- pierce-, R 3q Rs 1
GRIMES A/C State LicenseRA-0018071
Original General Contractor (or Subcontractor)
SLC License 4426
State License SLC License
New General Contractor (or Subcontractor)
Reason for Change CANCEL PERMIT, HOMEOWNER APPROVED JOB, THEN CANCELLED
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 he cancelled if work has been performed.
SIGNATURE OF OWNER, (or ownedbuilder)
PRINT NAME
State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this
day of , 20 , by
who is personally know to me
or who has produced as ID.
Signature of Notary Date
*Only signature .required for change of
Revised 07/21/14
6q�
* ST ATURE OF NEW GENERAL CONTRACTOR
ram' r
PRINT NAME
State of Florida, County of St. Lucie County
The fo owing instrument was acknowledged before me this
day of. FF « , 2t by Megf.
(� TM f.S_ _ who ' personally know t
or who Pproduced as ID.
Signature of Notary Date e`�---
subcontra
SUSAN MONTENEGRO
' MY COMMISSION # HH 006984
EXPIRES: April 2,2026
Bondsd Thiu Nota Audllu Undenvritere