HomeMy WebLinkAboutrequest to void permit 30-Mar-2022 18:29 From RICHARD L WALTERMIRE. Phone #7724738368 FaxZero.com p.Z
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PLANNING &DEVELOPMENT S �jCk
` - BUILDING & ZONING DIVISIO
s 2300 VIRGINIA AVE
FORT PIERCE, FL 34982 9b,
(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 fled 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 arc 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: - "1 i_ * Permit Number: 2111.0213
Site Address: `�C ` N<����.[� �,,.';�; [�e` t)A;iT e 4C.•-•r littic f. -L -3'f i 10
Twin Rivers Property Maintenance Inc State License EC13006161 SLC License_
Original CC,subcontractor or owner/builder
N/A State License SLC License
New CC,subcontractor
Reason for Cancellation Work completed and inspected under permit 2006-0447
The undersigned does hereby agree to indemnify and hold harmless St Lucie County.its officers, ents and employees from all
costs,fees or damages arising from any and all claims of action for any reason,which may arise a result of this change of
contractor/subcontractor or cancellation ofpermit.A permit cannot be cancelled if work has, en performed.
SIGNATURE OF OWNER(or owner/builder) SIGNATURE GEN AI.CrOI A
,NTJ TOR(or new GC,as applicable)
PRINT NAME PRINTNAME— J "G / f Cir 1 r
State ofFtorida.County of St.Lucie County State of Florida.County orSt.Lucie County
The t'ollowing imt umem was acknowledged before me this llowing in3�j}'m��ent was acknowledged before me this
-- •-tL�of._ ._..... ...._._,20_.by �....day of_[L(LLI�i�.202 by
who is person:illy knuwa to me who is per;onatly known to
or who has produced__-_-- as ID. me orw 0 has produc �L („as ID.
7
Signature of Notary Date ,4i rc of NGJi ry Date
._� •, LESLYE SMIT-
Revised 04/15/16 t �. f? notary putlic-State r-:Cried
'i? rrA Ccmmiisicn o=H 21;7?^
µy Cvrm,
30-Mar-2022 10:28 From RICHARD L WALTERMIRE. Phone #7724738368 FaxZero.com p.1
Recipient Information
To: Planninqq and Development Services
Company: Building & Zoning Division Fax#: 17724621578 �dRMXOM
Sender Information sod a fax krfree
From: RICHARD L WALTERMIRE
Company:Twin Rivers Property Maint
Email address: twinriverspm@yahoo.com (from 107.209.189.37)
Phone#: 7724738368
Sent on: Wednesday, March 30 2022 at 2:27 PM EDT
Cancellation of permit request for 808 Shorewinds Dr Fort Pierce
01
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