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HomeMy WebLinkAboutCHANGE OF SUBCONTRACTORCog PLANNING & DEVELOPMENT SERVICES E BUILDING & ZONING DIVISION 2300 VIRGINIA AVE �C� RECEIVED FORT PIERCE, FL 34982 1p9 n& JAN 11 2019 (772) 462-1553 FAX 462-1578 c� �00 Q sT. Lucie county, Permitting PLEASE SELECT ONE OF THE FOLLOWING: 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 commer1eing 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 $50.00 fee for the Change of Sub - Contractor. CANCELLATION OF PERNHT — The cancellation of a permit is acceptable only if no work has been done. Cancellation of permit is to be signed and notarized by both the owner and qualifier of record. There is no fee for cancellation of the permit. Date: Permit Number: 1 9n 11 - on L03 Site Address: -534'1 ©QMcnr)LpAiL rcLP, FL 3Lf95 nn1 I-1QrV K C—VCM5c A(, 0-21�k-N FJOAACState License E13CO4 a$ SLC LicenseD$ &Ocp Original OC, subcontractor or owner/builder J_o)m AmSbmaii, et i m cmiScm Q w t State LicenseEC i2)Q0! O'6SLC License 30'(a-_-� New GC, subcontractor- Reason for Cancellation The undersigned es hereby agree to indemnify and hold harmless St Lucie Count , ' s officers, agents and employees fron costs, fees or ages ng from any and all claims of action for any reason, w may ar as a result of this change of con / c nttact r cancellation of permit. A permit cannot be c work as been performed. SIGN OF OWNER (or ownQe \,e-r) SIGNA G ONTRACTOR applicable) PRINT NAME RO�Ck Jt'f\\'tY\W\C,� PRINTNAME ?obe(k-5(7% %wytA. State of Florida, County of St. Lucie County The following innstrument was acknowledged before me this '�%dayo ,11 WQA._. 20g, by who h . . of Notary Date Notary public Stata of Flodtla Revised 04/15/16 � � Nadia K Lefevre ���iA Eu Commission GG 24W71 pn giros 082812022 State of Florida, County of St. Lucie County e. following instrument was ackn I dge of re me this ih.1day of20,J_y, by,�. ,Sf I�1T1 IU _ who ape sonally known [ who has produced n as ID. Notary public State of Florid, Nadia K Lefevre Expires 08/282022 My Commission GG 246771 sa n.