HomeMy WebLinkAboutCHANGE OF CONTRACTORSCANNED 1
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 S50.00 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 S50.00 fee for the Change of Sub -
CANCELLATION OF PERI�IIT — The cancellation of a permit is acceptable only if no work has been done.
lation of permit is to be signed and notarized by both the owner and qualifier of record. There is no fee for
ation of the permit.
01/0412D19
ite Address: " t,
Meeks
GC, subcontractor or
Permit Number:
License CFC057372 SLC License
liidgeway Plumbing / Gregory Kozan State License CFCOTR54 SLC License
New GC, subcontractor
Reason for Cancellation Meeks Is off the Job
The undersigned does -hereby agree to indemnify and hold' harmless St Lucie Cbiinty.. its officers; agents and employees fron
costs, fees or_4ftages arising from any and all claims of action for any reason;-whic11
se Msult`of this change of
contractor' o tractor or cancellation of permit. A permit cannot be cancel if w `s be ,performed.
SIGNATURE OF OWNER (or owner/builder) SIGNA GE , I � NTRACTOR (or new GC, as nppl%ab(e),
PRINT NA.rIE Sdan W Davidson pm TNAME regory Kozan
Starr or Florida, County of St Lucie County State of Flonds, County ofSt Lucie County
The following instrument was acknowledged before me this 'the lollowing Instrument was acknowledged before me this
day of January 20 +9 . by day or__—_-. 20 ,, , by
t is penanally known to me
as ID
01/0412019
of Notary Date
Revised 04/15/16
rc
a ; ,7
personally known who is personally known to
me who has produced ID019
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