HomeMy WebLinkAboutChange Of ContractorPLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION RED
2300 VIRGINIA AVE
FORT PIERCE, FL 34982 NOV 2 0 20V
(772) 462-1553 FAX 462-1578
CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMT
PLEASES I.ECT 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.
0 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:
11/15/2017
Site Address: 429 NETTES BLVD
Permit Number:
1710-0188
EDDIE GRUNDEL State License IH1118467 SLC License
Original GC, subcontractor or owner/builder
RONNIE BLAINE
New GC, subcontractor
Reason for Cancellation
DUE TO WORKLOAD
License IHIIO1137 SLC License
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 can ellati n f permit. A permit cannot be cancelled if work has been performed.
IV v _
SIGNATUPY. OF OWNER (or owner/builder) SIGNATURE GENERAL CONTRACTOR (or new GC, as applicable)
PRINT NAMiJ)1U "t66 WAUkM— PRINTNAMF EDDIE GRUNDEL
i
State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this
75 dayof NOV 2d1by-
15W
i�U�l�ho is personally known to me
,— who has produced znas ID.
NANCY MIMS ARMSTRONG
MY COMMISSION # FF197399
i 49"ES February 10, 2019
State of Florida, County of St Lucie County
The following instrument was acknowledged before me this
1s day of NOV 20 1? by EE'E GRUN00.
who is personally known to
me or who roduced FLEX &ff.
Si natu ,Notary Date
NANCY MIMS ARMSTRONG
MY COMMISSION # FF197899
''?dr EXPIRES February 10, 2019
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