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HomeMy WebLinkAboutCHANGE OF SUB CONTRACTORPLANNING & DEVELOPMENT SERVICES " BUILDING & -ZONING DIVISION D �F� ® 2300- VIRGINIA AVE FORT PIERCE,: FL' 34982 s�'`��� �2 ° (772) 462-1553 FAX 4624578 �9°P ®� CHANGE OF CONTRACTOR SUBCONTRACTOR OR CANCELLATION OF PERMT SG PL'EARF SELECT ONE -OF THE FOLLOWING: S LUCIL' C�UtIy CHANGE OF CONTRACTOR — Change of Contractor is'to be signed and.notarized.by the prcjperty 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 fo'r job values. greater than- $2;500 ($7,500 if A./C. Change -out). "A recorded. copy .must be: -submitted. prior to. c7encing 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 subcontractormust fill out a Subcontractor Agreement'Form. There is:a $50.00 fee for the Change of Sub - Contractor. 73 EL C,© CANCELLATION OF PERMIT — The cancellation of.apermit is acceptable only if no work has been done. - Cancellation of permit is to -be signed and notarized by both the owner and qualifier of record.- There is no fee for cancellation of the permit. Date: 1202019 Permit Number: 181.1-0386 { i 73 EL CAMINO REAL Site Address: •��, j a 22 y7 WILLIAM BRANTLEY State License . SLC License J Original GC,:subcontractor or owner/builder ERIC WYNNE State License SLC License 29524 New GC, subcontractor Reason for. Cancellation . The.undersigned does hereby agree to indemnify and hold harmless St Lucie County, its, officers, agents and employees from all costs, fees or damages arising from any and all claims of action.for any reason, which may arise as a result of this_ change of contractor/sub co a tei-o�ricellation of permit. A permit cannot -be cancell 'f work has been performed. SIGNATURE OF OWNER (or owner/builder) SIGNATURE GENERAL CONTRACTOR (or new GC; as applicable) PRINT NAME MATTHEW LYLE WYNNE PRINTNAME ERIC WYNNE State of Florida,, County of St. Lucie County State of Florida, County of St. Lucie County The f. ollowing instrument was acknowledged before me this The; f wing instrument was acknowledged before me this . > MA7THEW LYLEYNNE. ay of ECEM�iI�.'20 1 q :by ERIC WYNNE' S day of l CCCC17*69?220 1_1, by ,y� • owerw iYCF W Y104ho is personally known to me who is personally known to or'who has produced as ID. J me or who has. produced as ID. l.J,, •4 849� / /9 444AwYL�`•bb.o�:12'2019 Signature o tary Date Signature allotary Date - Y:;e�;., DOROTHYANNBASKIN ^,�:a?;a', DOROTHYANNBA$KIN . Revised 09/15/1 :i�' •: = MY COMMISSION#GG030145's v M, COMMISSION # GG 030145 is EXPIRES: October 2,2020 w. i.G,= EXPIRES:October2,2020 F Bonded Thru Notary Public Underwriters 1 ry �� Bonded Tfiru Notary Public Underwriters i