HomeMy WebLinkAboutCHANGE OF CONTRACTORSCANNEL,
BYY3^-t �r•`�+,
iLude couft,
PLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION _ .
2300 VIRGE41A 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
sactor 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-
itractor.
CELLATION OF PERTNnT — The cancellation of a permit is acceptable only if no work has been done.
of permit is to be signed and notarized by both the owner and qualifier of record. There Is no fee for
of the permit.
01104/2019
Permit Number:
Address: ft-`!,,tCLikk Ii
GC, subcontractor or ownerlbuilder
Plumbing / Gregory Kozan
GC, subcontractor
in for Cancellation Meeks Is off the Job
License CFC057372 SLC License
License CFC057754 SLC License
ndersigned does'hereby agree to indemnify and hold`hari iless St'Lucie Couhty, 6 officers, agents and employees fr'on
fees or. ages arising from any and all claims of action for any reason, whic ise, • result of this change of
I
ctor' o tractor or cancellation of permit. A permit cannot be cancel f w s be performed.
ITURE OF OWNER (or ownedbuilder) SIGNA RE GEN l NTRACTOR (or new GC, as applicable)
T NAND Brian W Davidson PRINTNA,1E, regory Kozan
i of Flo0da, County of St ` t geYeCaunty
foltowing.uistrument was acknowledged before me this
day of January Z0 " . by,
y known who is personally known to me
produce ' nssID
jf Q�M�ir OIIW2019
or Notary Date
ed'04/L5A6
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rr t Js�.i 'kY.
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Slate of Florida, County ofSt Lucie County
mie Ibllowing auuument was acknowledged before me this
personally known who [s personally known to
me y who has produced u ID
Q4l2019
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