HomeMy WebLinkAboutCHANGE OF SUBCONTRACTOR.W'p
PLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION
2300 VIRGINIA AVE RECEIVED
FORT PIERCE, FL 34982 JAN 1 1 2019
(772)462-1553 FAX 462-1578
ST. Lucie County, Permitting
CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION %C T_
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
commeeleing 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:
Site .1
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Original 6C, subcontractor or owner/builder
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New GC, subcontracto
Reason for
The undersigned es hereby agree to indemnify and hold harmless St Lucie Coun , ' s officers, agents and employees from all
costs, feesUOF
g from any and all claims of action for any reason, w may as a result of this change of
Zontrcancellation of permit. A permit cannot be c work as been performed.
ne \,e_r) SIGMA G ONT 1RAC4TO�� \ `_ applicable)
PRINT NAME- Rc)�OP_Ck \tY \1JJ\C-K PRINTNAME �OVe0— Ji 11N'Y1U3VLX
State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this
-4%day ofBwg,
20A_q,by 9obeJh
�Anioc_
who pers_lywe
/who has produced
as ID.
LSignature of Notary
Date
Revised 04/15/16 i
of Florida
249771
State of Florida, County of St Lucie County
T�e following instrument was acl s wled a re me this
iA+ day of 20IN by�
Sx�l�V�,Wtue who s persona ly mown t
tyre qr who has produced Z�as ID.
Date
ap°ky_ Notary public Slate of Floods
s' Nadia K Lefevre
2 � d° My Commisslon GG 24677,
oew Expires 08/282022