HomeMy WebLinkAbout request to void permit- already has done a change of contractor 03/09/2022 13:14Como 0i I and Propane (FAX) P.001/001
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- ' lWh BUILDING& ZONING DIVISION ���NEV
2300 VIRGINIA AVE P
FORT PIERCE,FL 34982 Mph 0 �ri��9
(772)462-1553 FAX 462-157$ Go J�� Peter
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CHANGE OF CONTRACTOR SUBCONTRACTQR OR CANCELLATION OF PERMT
PLEASF SFLFCT 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: 03/07/22 Permit Number: 3LC-2202-0090
Site Address: 11850 Appaloosa Ct Pt St Lucie
Como Oil&Propane State License LQ33288 SLC License #37717
Original GC,subcontractor or owner/builder
State License SLC License
New GC,subcontractor
Reason for Cancellation Customer decided not to complete job with Como.
The undersigned does hereby agree to indemnify and hold barmless St Lucie County,its officers,agents and omployees from all
Costs,fccs or damages arising from any and all claims of action fpr any reason,which may arise as a result of this change of
contrac ubcontraetor or cancellation of permit.A permit cannot be cancelled if work has been performed.
sloNATORE OF OWNER(or owner/builder) URE� SIGNAT GENERAL CONTRACTOR(or new GC,u applicable)
PRINT NAME {-`I G1'l•AE, 1;0�t Vl - PRINTNAME�
Stan of Florida,County of St.Lucie County State of Florida,County of St.Lucie County
The following insttuotettt wag aclmawledged before me this The following htsh=ent was acknowledged before ma this
Id-ay of ma r�c1.�.�0�by day of ,20_,by
i c.l na e f `7 t7 (Vl eryh0 is poonally Imown to me who is personally known to
o who h pro N A s iD the or who has producod as ID.
t L C 09/07/22 03/07/22
Signature oPj of Date Signature of Notary Crate
NIOM 71li moon
Revised 04/15/16 Noury Public
Stas of Florida
Comm#NH197638
15�Irea i1/11/2025