HomeMy WebLinkAboutCHANGE OF CONTRACTORPLANNING &. DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION
NTY
2300 VIRGINIA AVE RECEIVEb
■ FORT PIERCE, FL 34982
SCANNED (772) 462-1553 FAX 462-1578 DEC 0 3 2019
St. Lucke Counbf I ST. Lucie County, Permitting
CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMT
V CHANGE OF CONTRACTOR — Change of Contractor is to be signed and notarized by the property owner,
and he new contractor of record for the current permit. A new permit application must also be completed with new
con, actor information and signature. A new Notice of Commencement must be filed in the new contractor's name
for ob values greater than $2,500 ($7,500 if A/C Change -out). A recorded copy must be submitted prior to
co encing any work. There is a $50.00 fee for Change of Contractor.
CHANGE OF SUBCONTRACTOR - Subcontractor changes are to be completed by the general contractor.
The ew 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.
If 14S X�o Permit Number: 5zf— "0 Ag. 7
Site Address: ? L:11611107 I fIl /E 6 ()01'
i
e S Q �Jr State License SLC License 27 l 3
ri .I nal GC, subcontractor or owner/builder f
f
--I "C- State License.UyQ 0(Q-i )SLC License
New GC, subcontractor
Reas 'forCancellation
i
The i0dersigned doega
to indemnify and hold harmless St Lucie County, its officers, agents and employees from all
costs, ees r damageany and all claims of action for any reason, which may arise as a result of this change of
contr ct /s contraati f permit. A permit cannot be c e ed if work h ee performed.
IG OF OV.114ER (or own' r/bufl er) SIGNA GENERAL CONTRACTOR (or new GC, as applicable)
PRIN NAME � V /� . Und PRINT NAME
State of Florida, County of St. Lucie County State of Florida, County of St. Lucie County
The too owing instrument was acknowledged before me this Th f��lowing ins ment was acknowledge fore me this,
2 day of oVc rL c1201�1 by JrA % day of Jcr, 20J, by , r we.\
who is personally known to me who is personally known to
I l
or who p oduced as ID. me �rlw produced ✓ as ID. /
Signs re of Notary Date Signature of Notary Date
Revi6��,7
/ ldotary Public State of Florida Notary Public State of Fbride
Colleen Sue Hayes ;P%
My Commission GG 287729 My Commission GG 287729
Expires 03/15/20W Ij Expires 0311512023
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