HomeMy WebLinkAboutCHANGE OF SUBCONTRACTORW
PLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION ERECEIVED
2300 VIRGINIA AVE
FORT PIERCE, FL 34982 I 1 2019
(772) 462-1553 FAX 462-1578unty, permirong
BY
PLEASE SELECT ONE OF THE FOLLOWING: St. Lucie County
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
contractor 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
comme ng 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 subcontractor must fill out a Subcontractor Agreement Form. There is a $50.00 fee for the Change of Sub -
Contractor. •
CANCELLATION OF PERMIT — The cancellation of a permit 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: Permit Number:
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Reason for Cancellation ' -
The undersigned es hereby agree to indemnify and hold harmless St Lucie CounXi officers, agents and employees from all
costs, fees or ages ar' ng from any and all claims of action for any reason, w may ar' as a result of this change of
contr3e ' c ntract �r cancellation of permit. A permit cannot be c work as been performed.
PRINT NAME 'Rp\Q_-Vk
State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this
4.%day of�,
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J who s personally known t e
who has produced
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Signature of Notary
Date
Notary Revised 09/15/169 EMNxyapdClreioatmre
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State of Florida, County of St. Lucie County
e following instr u tent was aclm wledg a re me this
N'� day of20Tby
,�Wm bU1UC who spersonallyknown t
rpe �r who has produced /l as ID.
Date
AP Y6 Notary public State of Florida
Nadia K Lefevre
2.� � My Commission GG 246771
1os is Expires 0&2a2022