HomeMy WebLinkAboutCHANGE OF CONTRACTOR SUB CONTRACTOR CANCELLATION OF PERMIT 9-5-18Sep 051 P 10:15a
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Big Lake Roofing �-F?epair 863�`7-7662
PLANNING & DEVELOPMENT SERVI(
BUILDING & ZONING DIVISION
2300 VIRGINIA AVE
�1 FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578
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SCANNED
St Lurie C®V,J1n1[Vl
RECEIVED
S E P 05 2018
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
xactor 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
tmencing 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 fell 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.
,Nation of permit is to be signed and notarized by both the.owner and qualifier of record. There is no fee for
Nation of the permit.
SEPTEMBER 5, 2018
Address: 90 SAN LUIS OBISPO FT. PIERCE, FL 34951
IG LAKE ROOFING & REPAIRS LLC
GC, subcontractor or ownertbuilder
GC, subcontractor
for Cancellation HOMEOWNER CANCELLED JOB
Permit Number: 1808-0446
License CCC046939 SLC License
License SLC License
he undersigned does hereby agree to indemnify and hold harmless St Lucie County, its officers, agents and employees from all
)sts, fees or damages arising from any and all claims of action for any reason, which may arise as a result of this change of
:)ntractor/subcontractor or cancellation of permit A permit cannot be cancelled if work has been performed.
GNATURE OF OWNER (or owner/builder) SIGNATURE . ERAL C0Nf9 r new GC, as applicable)
RINT NAME PRINT NAMEVIC'10 'tl�`l[j('f�7 �
hate of Florida, County of St. Lucie County
lie following instrument was acknowledged before me this
day of 20_____, by
who is personally known to me
r who has produced as ID.
SEPTEMBER 5, 2010
tune of Notary Date
sed 0411511E
State of Florida, Counry of St. Lucie County
The lowing rnstnmen was ac �_wledged before thiss�
CL- ay of , 20'by
who is personally known to
me or who has produced as 1D.
Signp �� SEPTEMBER S, 201a
e of Notary Date
...........HEATltER EDWARDSON
e« .- MY COMMISSION # GO 215185
EXPIRES: May 21, 2022
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