HomeMy WebLinkAboutCHANGE OF CONTRACTOR% �11 /��gyp�1 R
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PLANNING & DEVELOPMENT SERVICES BY
BUILDING & ZONING DIVISION
2300 VIRGINIA AVE RECEIVE®
FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578 J U L 10 2 0 18
ST. Lucie County, Permitting
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 -
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.
-\ -ate-Ngc
Permit Number: \%,� -
Address: N30N% fie.. V-!S R79�,,Z 7Z;am %, %ck 'RL. IySR 5�
License Q&nC-AOkS-111SLicense
GC, subcontractor br owner/builder
License C1 C60S7d6 SLC License
GC, subcontractor
for Cancellation
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
r--act''or/subcontractor or cancellation of permit. A permit cannot be cancelled ifworkhas been rformed.
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ATURE OF OWNS or owner/ ' er) SIGNATURE GENERAL CONTRACTOR (or new GC, as applicable)
JT NAME PRINTNAME(;;;�>\CP—C�
S to of Florida, County of St. Lucie County State of Florida, County of St. Lucie County
rT�H following instrument was acknowledged before me this RivJk1Iowing44FWument was aclrn �bef rQ a me this
d day of \ 20)X by �Lday of Q 20� by V_0X:xQC
who is personally known tome h� �-A- who is personally known to
or ho has produced M as ID. me or who has produced as ID.
Si ature of Notary Date,, Signature of Notary Date
`o��aYPU STELLA M. HUNTER `,,uV""",,,, STELLA M. HUNTER
_ Notary Public - State of Florida vPp to I'� sed o4/15/16 = " Commission # FF 180552 Ir.Tn: Notary Public - State of FloridaMy Comm. Expires Jan 23, 2019Commission # FF 180552 9F My Comm. Expires Jan 23, 2019
Bonded through National Notary Assn. OF F�pp,�
"""�� Bonded through National Notary Assn. '