HomeMy WebLinkAboutChange of ContractorCOUNTY t
F L O R I D A
and the new contractor t
contractor information
for job values greater
commencing any work.
CHANGE OF!
The new subcontractor
Contractor.
CANCELLATI
Cancellation of permit
cancellation of the per;
PLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION
2300 VIRGINIA AVE I
FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578
THE FOLLOWING:
,1
O NTRACT_O_R — Change of Contractor is to be signed and notarized by the property owner,
ecord for the current permit. A new permit application must also be completed with new
I signature. A new Notice of Commencement must be filed in the new contractor's name
an $2,500 ($7,500 if A/C Change -out). A recorded copy must be submitted prior to
here is a $50.00 fee for the Change of Contractor.
BCONTRACTOR — Subcontractor changes are to be completed by the general contractor.
tst fill out a Subcontractor Agreement Form. There is a $50.00 fee for the Change of Sub
w OF PERMIT — The cancellation of a permit is acceptable only if no work has been done.
to be signed and notarized by both the owner and qualifier of record. There is no fee for
Date: April , 2022 'I
I�
Site Address: 6377 Chaska St. Fort Pierce, FL 34982
Permit Number: 2108-0007
Timothy & Wendy Cook
or owner/builder
State License n/a SLC License n1a
Original GC, subcontractor
Villanova Construction Inc.
State License CCC 1327240 SLC License
New GC, subcontractor
Reason for Cancellation Piermit
time expired and did not get final inspection
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 permit. A permit cannot be ancelled if work has been performed.
® i �
c
SIG ATURE OF ER (or owmer/builde.l
IGNA E GENERAL CONTRACTOR (or new GC, as applicable)
PRINT NAME —lit 1A04 � d�IO
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PRINTNAME�e:jL171 JIVZ) de ll/4.4fZ ✓ ►%d
State of Florida, CountyofSt. Lucie" County
State of Morida, County of St. Lucie County'
The following instrument was dclaltowledged before me this
The following ins ent t acknowledged before me this
day of nr
-3a—day of 1�1,t�. ip R b=0 _' � K
-
� V*y
w is personaliy know o me
G
!L who is personally known to
(who has produced as ID.
me or who has produced as ID.
riI , 2022
v April 2022
Signature orNotsa��� I •,• �ttc ����
r Sk6atufe%f l�o� } �`{'�'4D_'ate
Revised 04y15/i
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69
SHIRLEY K. BEMENDERFER
commission # GG 949510
o Expires May 8, 2024
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