HomeMy WebLinkAboutCHANGE OF CONTRACTOR SUB-CONTRACTOR CANCELLATION OF PERMITPLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578
SCANNED
BY
St• udeGoanty
CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMT
PLEASE SELECT ONE OF THE FOLLOWING:
CHANGE OF CONTRACTOR — Change of Contractor is to be signed and notarized by the property owner,
and the new contractor of record for the current permit. A new permit application must also be completed with new
contractor information and signature. A new Notice of Commencement must be filed in the new contractor's name
for job values greater than $2,500 ($7,500 if A/C Change -out). A recorded copy must be submitted prior to
commencing 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.
The new subcontractor must fill out a Subcontractor Agreement Form. There is a $50.00 fee for the Change of Sub-
ctor.
ANCELLATION OF PERMIT — The cancellation of a permit is acceptable only if no work has been done.
Cancellation of permit is to be signed and notarized by both the owner and qualifier of record. There is no fee for
cancellation of the permit.
Date: ° Permit Number:
Site Address: a p00 S me
GC, subcontractor or oWner/butld?
New GC, subcontractor
Reason for Cancellation
�3 D e-- OZ'� 7
License SLC License
State License SLC License
The 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 mason, which m arise as a result of this change of
contra tor/ subcontractor o ancellation of permit. A permit ca not b cane Hed if o has been performed.
- 'a F OVltN1 R (or owner uildee}r) ``"CIE GN'�Tt< WAGE E1 Wk'' CONTRACTOR (or new GC, as applicable) (�
PRINT NAME 1 �� ��r( (� �- PRINT NAME ��y �" � ) )eiP-4
State of Florida, County of St. Lucie County
The following instrument was acknowledged before m1 ee this
day of 20A, by3 o
a � ) r�G ! t who is Dersonally-mown to me
or
Signature
Date
Revised 04/15/16
,.•PCB-,, AUDREY B. HUMPHREY
MY COMMISSION # GG 30061
EXPIRES: March 6, 2023
tots t,
Public Undetwti
r,, •.; �F s Bonded Thru Notary
�%, vu iesc:'�'re�natsza
State of Florida, County of St. Lucie County
Th�lowing i ment s ackggtvledge before me this
day of 20,�J�rf�''_ by S(
who �p'e`rsogalV} 11
prown to
me or w has duced a ��
Signature of Notary Date
—'-��--
'=,
�;
REY
AUDREY B• HUMPHq
MY COMMISSION # GG 300617 1�?
6, 2023
`
EXPIRES: March
nded tary Public Undeneriters 1.
Page 1 of 1
- Co
BUILDING &CODE SYSTEM You are logged s: STLUCIECO\galt
31.
85: Version 31.
�yyi L#FFf11e6I Vp 0rjtUdlljPermit I Search Permit I Review I Inspection I Permit Fee/Pay I Misc Fee I Contractor I Reports I Maint I Fiscal I Flood Log I Front Count I ERD I Green Cart I Energy Calc I Er
View, Edit, OR Add Parcel Alerts
ubmitDuery Print 'FROPERTYALERTS =` SCANNED
r
Enter Parcel Id: (Press ENT 113016040MIOOO aBY
r-3t. LHOP f nunty
PROPERTYINFORMATION
Parcel #: 1301-604-0123 10010 Jurisdiction: SAINT LUCIE COUNTY Zoning: jRESIDENTIALI SINGLE FAMILY-4
Address: 18005 BELMONTAVE, _ ,;, FORT PIERCE FL,:` I 34951.
- PROPERTY ALERTS
Add Alert l�rccaur•
................-.. ...................- .....
Alert Severity 1 Alert Status Alert Type
Delete Edit SWO/DOUBLE FEE I ACTIVE I ENFORCEMENT
YELLOW -- CODE
Delete Edit CONDTfIONS MAY ACTIVE j ENFORCEMENT
I APPLY
Alert Desaiption
CASE: 95686.OFFICER: DANA. DOUBLE FEE. RENOVATION WORK
INCLUDING CONVERTING LIVING SPACE TO GARAGE, NEW
GARAGE DOOR, ELECTRICAL, HOT WATER HEATER, INSET. CARL
WANTS CONFIRMATION THE GARAGE DOOR DOES NOT GO
STRAIGHT INTO A BEDROOM.
NO FENCE AROUND EXISTING POOL. NO DOUBLE FEE SINCE
FENCE IS NOT INSTALLED AT THIS TIME BUT NEEDS A FENCE AS
BARRIER FOR THE POOL. OFFICER: DANA. CASE: 95686.
Closed By I Date Closed I Last Char
difrance
08/1512
difrance
08/16/2
):Hcode/(S(omxultarcwn3xsrumdlOxoja))/AlertMaintenance.aspx 8/16/2018