HomeMy WebLinkAboutCHANGE OF CONTRACTOR-SUB CO0NTRACTOR - CANCELLATION OF PERMITPLANNING & DEVELOPMENT SERVICES RECEIVED
BUILDING & ZONING DIVISION SEP 21 2018
2300 VIRGINIA AVE Permitting Department
FORT PIERCE, FL 34982 SCANNED St. Lucie Countv
(772) 462-1553 FAX 462-1578 BY
St. Lueb Gotipty
CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMT
_11 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
con actor 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
corr. encing 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 �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.
Cami,ellation of permit is to be signed and notarized by both the owner and qualifier of record. There is no fee for
cani ellation of the permit.
Q�Jblt-�
Da : Permit Number:
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o s
dc State Licens . �WIOSLC License
'nal GC, subcontractor or owner/builder
Ori
State License SLC License
GC, subcontractor
Ne
7:1 pewn
Reas
n for Cancellation
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 any reason, which may arise as a result of this change of
conti
ctor/subcontractor or cancellation of pen -nit. A permit cannot be cancelled if work has been performed.
- &IL (� L/�K.
[TUBE OF OWNER (or owner/builder) SI TURE GENERALCONTRACTOR(or new GC, ass alppliclab e)
SIGN
PRI
P NAME PRINT NAME�I c {�-C _ [ Ix 9- Y LD .l
State
6f Florida, County of St. Lucie County State of Florida, County of St. Lucie County
The
Ilowing instrument was acknowledged before me thus f 11 mg ' stm nt w s ackn wled efor a this
ay o 03 by�
day of 20by
who is personally known to me who is , nemonally known to
has produced as ID. has produced as fMgAz�-, No
cj/
re of Notary Date Signature If Notary Date
or wh
Signa
.�YP�% ALYSSA BLACKSHEAR
..
s,6=State
Revi
ed 09/15/16 r° of Florida -Notary Public
=' '= Commission # GG 237887
My Commission Expires
July 12, 2022