HomeMy WebLinkAboutChange of Contractor (2)PLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION
2300 VIRGINIA AVE
FORTPIERCE, FL 34982
(772) 462-1553 FAX 462-1578
CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMT
PLEASE SELECT ONE _ OF THL FULLnWING:
CHANGE OF CONTRACTOR — Change of Contractor is to be. signed and notarized by the property owner,
and the new contractor ol'rccord 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 tiled in the new contractor's name
for job values greater than $2,500 ($7,500 if A1C Change -out). A recorded copy must be submitted prior to
conuuencing any work. There is a $50.00 fee for the Change of Contractor.
x CHANGE OF SUBCONTRACTOR — Subcontractor changes are to be completed by the general contractor.
The new subcontractor must till out a Subcontractor Agreement Form. There is a $50.00 fee for the Change of Sub -
Contractor.
CANCELLATION OF PERMT -- "lire. 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:
Permit Dumber: r9001/
Site Address: _ .5g6 �, 31 UJ ,
Ci _--- ----- - -State License_ CJ14I>%3b51.0 License
Orlgif al GC, subcontractor or nwnerrintilcier
Orlgif�lal
C1' iCal _ �1cEf_Y__ (,� State l_,icense_Vd—E��tb7SLC Liccnse__ t749--
New GC, subconvactor
Reason for Cancellation
The undersigned does hereby agree to indeninify and hold harmless St Lucie County, its officers, agents and employees from all
costs, fees or datrLsges arising from any and all claims of action for any reason, which may arise; as a result of this change of
contracwr'subcontiataor or cancellation of lvvnit. A permit cannot be cancer ed if work has been performed.
__.
Sl(,NdA-FURL Cn �OWNW.R (oi- owmenbuilder) SIGNIA1 URE GE,4E CO�T�RACTOP for�rim GCS. A,-; applicable)
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Suatc of Florida, C'otnty of St. Lucie Cwli[y
The ('ohowing instrumchn ware ackmraed rcl before nu (lik
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YEE
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Star: at t�tida. C'aunty of St. Lucie County
the following ii tnirrnicnt waq acknowledged befure me this
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e r who has Pr uced d� In.
signature of 'Notary Dare
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