HomeMy WebLinkAboutSpencer permit cancelPlanning & Development Services
Building & lode Regulations Division
it �300 Virginia Ave.
4 . - rV ort Pierce, FL 34982
- (772)462-1553 Fax 462-1578
CHANCE 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 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. 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: j Z
Permit Number: 2 I l 1— O .`> O
ry�
Site Address: � �y-I- on �6U& �I �
"f h
---k 1(-tr CJ+z- I /� Co State Licensee SLC License Z 96 51
Original General Contractor (or Subcontractor)
State License SLC License
New General Contractor (or Subcontractor)
Reason for Change 60 C - I � tk�-1 0 n
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
Pe A PermYt cannot be cancelled if work has been performe) L,---
SIGNATURE OF OWNER (or owner/builder) * SIGNATURE OF NEW GENERAL CONTRACTOR
PRINT NAME 1—e+0(ir-Af, LU PRINTNAMEF—C)G
State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this
day of MXG66 20 LL by C 71 f 1.S 1nl 0 0
who is ers know to me
or who has produced as ID.
47
Signature of Notary Date 3 j� j7 2
*Only signature required for change of
Revised 07/21/14ENotary Public State of Florida
ris Woolley
ommission
229552
. 2/26/2026
State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this
j'IhAyof,V T , ,20LLbyGkfl) W00!1fj
who is personally know to me
or who has produced as ID.
Signature of Notary Date
s
subcontractor ' =229552
NotaryFlorida ChMy Clilt H29552 Exp