HomeMy WebLinkAboutCHANGE OF SUB CONTRACTORPLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578 `sC
CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMT t^��C04
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 ust also be completed with new
contractor information and signature. A new Notice of Commencement must be filed in the new contractor's name
for jib,, values greater than $2,500 (S7,500 if A/C Change -out). A recorded copy must be submitted prior to
com encing any work. There is a S50.00 fee for the Change of Contractor.
x � 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 -
CANCELLATION OF PERIM —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
atioo of the permit.
Datel. 01104P19
Permit Number: 1 k r
Site Address:
Meeks State License CFC057372 SLC License.
Original GC, subcontractor or ownertbuilder
Ridgeway Plumbing / Gregory Kazan State License CFCOFn54 SLC License
New GC, subcontractor
Reason for Cancellation Meeks Is off the Job
The` 9dersigned does,hereby agree to indetnnifyand hold harmless 'St Lucie County,`itsbfftcers,,agents and employees frog
t:osts, (fees of ges arising from any and all claims of action for any reason, whi c se- result of this change of
conwct.0 ontractor or cancellation of permit. A permit cannot be can f w bt; . performed.
SIGNAIRIRE OFOWNER (or owneribuilder) SIGNA GEN N- MCTOR (or new CC, as applicable)
PRINT NAME Brian W Davidson PRINT NAM fi regory Kazan
i
State of Florida, Countyof St Lucie County state of Flonda, County of St Lucie County
The following instrument %w acknowledged before me this The ibllowmg utstrumcm was acknowledged before me this
1 day of January 20 t_ 9 , by °' day of A- 2019 , by
ermonally known who is personally known to me personally known who is personally known to
crjQ4, has pro du __as ID me who has produced as ID
'E&74�q 011=019 �.+t. 041201 g
-allure of Notary Date sie-at re or,Yotary Date
P.evis�ed 4A/15/Eli j(CTricfEti!'•H"''�-
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