HomeMy WebLinkAboutCHANGE OF CONTRACTORs
Planning & Development Services
Building & Code Regulations Division
2300 Virginia Ave.
Fort Pierce, FL 34982
(772)462-1553 Fax 462-1578
CHANGE OF CONTRACTOR
Or subcontractor or cancellation of permit
SCANNED
BY
St Lucie (, "tY
Change of Contractor is to be completed 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,
signature, and transfer fee. A new Notice of commencement must be filed in the new contractor's
name for job value's greater than $2,500 ($7,500 if A/C Change -out). A recorded copy must be
submitted prior to commencing any work. Subcontractor changes can be completed by the general
contractor. Any cancellation of permit is to be executed by both the owner and qualifier of record.
Date: I — I 1 — i (A
Site Address: 6 D 1
Permit Number: 06 0 00?
VA. 6 n,,z s I 1,\k C State License SLC License
Original General Contractor (or Subcontractor)
LG 54 C& N N A K t? State License SLC License
New General Contractor (or Subcontractor) It
Reason for Change
The, undersigned does hereby agree to indemnify and hold harni d&s St. Lucie County, its officers,
agets, 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/subcontractor or cancellation of
rmit. A permit cannot be cancelled if work has been 7GNOA"
rmed.
SI ATURE OF 0 (or owiidr/builder)Q •GENERAL CONTRACTOR
PR T NAME L. ES / E � 6 U 1►i C' PRINT NANM L li STL 6 G LJ R K C-
State of Florida, County of St Lucie County
The following instrument was acknowledged before me thi6
day of l . 204 by—L_�p
who is personally know to rt
'ry ANGELA M. HIy re—
MYCOMMON #EE 053530
change of
State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this
, day of �. 204 by
who is personally know to e
or o has produced
Signature of FGELAM.HUFF
p, BSION#EE 0n530
MY CO AMI
EXPIRES: April 12, 2015
Bonded Tlw Notar/Pu66c0nde�wdters