HomeMy WebLinkAboutCANCELLATION OF PERMITr7l
PLANNING & DEVELOPMENT &
BUILDING & ZONING DIVISION
2300 V1RiGINI4, AVE
FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578
MAY 10 H'19
ST. Lucie
PLEASE SELECT ONE OF 7M POLLM4Q BY y
—• C ANGEofit7o MUiCTOR- St. Lucie Count
hangc_of ContraWoira.to i s si&3gd a_dnotn ized by -,the property owne�
and thehew contractarofrecord forthe current permiL A new: permmt application -must also be completed with new
contractor mfororahon and stgnatlrre A new ➢7c/icedf'Cemmercerrent,must be filed in the n&W,eontraetor%, name
for job' 4alne`s greater .than $Z,500 ($7;500, rf _A/C' Change out): A! recorded) SPY must be .sutiiningt ',;ter _ _
CHANGE'OF'DoUSf' TRACTOR Stitbcontraetei changes sre to be completedi *M.genera] oeo�aoic The new sobcoDtiactbrmust fillout a SubcontractorAA&6' lfic`nt Form. There ls�a;$SO.okfee:foi• the Change _-Sah CoDtrsctor. — _ a.
CANCELLATION OF PERMIT — The cancellation of a permit is acceptable only if no woi& fins been done.
Cance]lation ofpermit-is to Ibe.signed:and notarized by b6th_the owner and qualifiei ofrecvid There is no fee for
cancellation of.the permit. _
Date: 6/6/2019
Site Address: xx
Permit Number: 1962-ds1
PetetsenDean Roofing & Solar Inc. CCC1329081
Original GC, subcontractor or owner/builder State License SLC License
New GC, sttbc u1bnetnr State License SLC License
Reason for Cancellation Customer do not want to proceed With roofing project.
costs, fees or dame " --- - J """ ""'"'s "'-"cj3 �r'L come �outny, its orDcers, agents and ernployees.from aR
g To and all ctaims ofaction for any reason, which may arise as. a result of this change, of
ctor/subcontractor a. - cellatjon ofpetmit. Apermit cannot be cancelled ^ ork has bee
ATtIREOF orowncrlb _dcAi .Sb3�lATURE EN
_OR (ornew ___as sOPlirabte)
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State ofFloride. Cwnty or St Lucie Cmay Sale ..- .
_OrF)FMa6 CmanyofSt Lucie Canty
T1100:Qow9ogym�r,�{,want. wan aellmow befom methis foJ�sc
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- day of '!'�j�6 .. Dnhjg J� .�!a yof meat w-21se"oy ,�Iged liefinenu tli'tt
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wgnstnreotrYbtary
U Date
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ANNEMAgIF SINGER
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,
Notary Public: • State Of Florida
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Commission a GG.085884
MY Comm. Expires Mar 22. 2021
Date
A'" BETH WAGNER
., MYCOMMISSION# GO 081027
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