HomeMy WebLinkAboutCHANGE OF CONTRACTORICANNED
BY
•
PLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578
CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMT
CHANGE OF CONTRACTOR — Change of Contractor is to be signed and notarized by the property owner,
the new contractor of record for the current permit. A new permit application must also be completed with new
tractor information and signature. A new Notice of Commencement must be filed in the new contractor's name
job values greater than $2,500 ($7,500 if A/C Change -out). A recorded copy must be submitted prior to
imencing 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.
new subcontractor must fill out a Subcontractor Agreement Form. There is a $50.00 fee for the Change of Sub-
itractor.
_CANCELLATION OF PERMIT — The cancellation of a permit is acceptable only if no work has been donei
icellation of permit is to be signed and notarized by both the owner and qualifier of record. There is no fee for;
cellation of the permit.
Permit Number: 0
S4 Address: `C C�1(�G-�C�e s� �� (2 r� 3 �\ (z:i Z
O i inal C�Subcontractor or owner/builder
gaaen
N 'w GC, subcontractor
for Cancellation
itate License SLC License
3ta� Li ense SLC License
undersigned does hereby agree to indemnify and hold harmless St Lucie County, its officers, agents and employees from all
fees or damages arising from any and all claims of action for any reason, which may arise as a result of this change of
ractor/subcontractor or cancellation of permit. A permit cannot be cancelled if work has been performed.
bn)
ATURE O0F OWNER�(or o5t�erlbul`d SIGNATUM GENERAL CONTRACTOR (or new GC, as applicable)
1 � �
of Florida, County of St. Lucie County
following instrument was acknowledged before me this
�Jay of %% Ja, 20A byjQ�
:?AAA �r. / who is Dersonallv known to me
ure of Notary ( f r"8)0aHdwnH'8AUanv
I Iw�(IWpuepun "qnd M" Rua PaMk
ed 04/15/16 COSONOISSIW OOM
PRINT NAME
State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this
day of , 20_, by
who is personally known to
me or who has produced as ID.
of Notary Date