HomeMy WebLinkAboutCHANGE OF SUB-CONTRACTORSCANNEDy
Sy
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
praetor 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
Imneing any work. There is a $50.00 fee for the Change of Contractor.
CHANGE OF SUBCONTRACTOR — Subcontractor changes a to b completed by th general contralto .
ff
e subcontractor must fill out a Subcontractor Agreement Form bete is a 50.00 fee for the khan a of Sub-
�fr�� nr
CANCELLATION OF PERMIT — The cancellation of a permit is acceptable only if no work has been done.
.ation 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.
Address: —g! f D it rrvl u^ 5
An tS'- ?r
;final GC, subcontractor or owner/builder
Permit Number: ,—o 2—
License SLC License
1 i! State License aU 0 7C License
GC, subcontractor
Reason for Cancellation
�he 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 a )e as been performed.
i -
ISIG]VATURE -'OWNER (or owncr/builder) AC SIGNATURE GENERAL
//C;O'NpTRACTORR (or new GC, as applicable)
`PRINT NAME PRINTNAME 4/1 //1(ACt�I / Il �lS`
State of Florida, County of St. Lucie County
The follmring instrument was acknowledged before me this
day of 20_ by
who is personally known to me
or who has produced as ID.
Signature of Notary- Date
Revised 04/15/16
State of Florida, County of St Lucie County
FheSollowing i strumcnt was ackn vledg bF re me thi
II j Yr'% day of V— , / 207 by /W Pl/C,&
who is peYcsoaally komm to
ru vho haspro/d{uc�ed as 1D.
GV 9
Si store of Notary Date 12-f r / e
f=':�`"�`rO<:9., JESSICA PRESCOTC
* * Notary Public, State of Florida
My Comm. Expires Oct 1, 2019
'9a.pMV..W `'= Commission No. FF 923361