HomeMy WebLinkAboutCHANGE OF CONTRACTORi
PLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION
1 1300 VIRGR AVE =RECEIVEDFMm ORT PIERCE, FL 34982 (772)462-1553 FAX 462-1578
CNANRF. F CONTRACTTR_ RTT_R(-nNTRACT0P 6111 CANCT1.T.T'.ATrnN (1Tt PT4.RMT
I i SCANNED
PLEAS ELECT 61 rE OF THE I : FOLLOWING r�BY�+
CH?ANGE F CONTRACTOR- Change of COntracRdi � fS�k Qggaf�hd notarized by the property owl
and the new contract r of record for'the' current permit. A new permit application must also be completed with r
contractor; information and signature. A new Notice of Commencement must be filed in the new contractor's na
for' job -values 'eater than•3$ ,500 ($7,500 if A/C Change=out). A recorded copy must be submitted: prior
commencing any wik. There is a $50.00 fee for the Change of Contractor.
CHANGE O SUBCONTRACTOR-' Subcontractor changes are to be completed by the general • contras
The'new s&ontri ci r must flout a Subcontradtor'Agreement Form. There is a $50.00 fee for the Change of Si
Contractor.
I li I i j,
CANCEL TI' OPERMT - �he cancellation of a permit is acceptable only if no work has been do
Cancellation of perii ut is to be ,signed and notarized by both the owner and qualifier of record. There is no fee
cancellation of the. I lermit.
`' �_ a=-
Date: �� Nm Permit uber:...a_ _y
I I !
Site Address:.r I I-; (—aKO LG i 1-d 2-
Original GC� subs
I+ i I- --
p1' �Glt
New, GC, sulicomi
Reason for Cancella'
I
The undersigned doi
- costs; fees 6> damag
con6acf,gubcontrA,
SIG9ATUREbV0WNt
I - - ---FRI,NT—NAME �
State of Florida, County,
I. ] I
e�K ,
or owner/builder j
j
I:
License CO_ _1 SLC License a7� 1 1
i
License (6C6I1157 SLC License 31 a I f 7
I;
'mnify, and hold harmless St Lucie County, its officers, agents and employee's from all
.d'all claims of actionifo'r any reason; which may arise as a result of this change; of
Epermit! A permit cannot be cancelled if o hfis been performed.
SIGNATUREGENE NTRACTOR(ornew GC,wapplimble)
Lay_)—_ - _ IN
.____PRT.NAmP-+ 3a mes-F
State of Florida, County of St Lucie County
me this- - - - - - - -The following instrument -was aclmowled before me this
02 �i't'd`ayof'ZTiA.2 .20�by�(.r->��-
I I
who has produced I -' as ID. me or who has pryqacedas ID.
(p('ai7�I�;
Signature of Notary Date j I Signature ofNota Date '
I
I I
i Notalry Publit State of Flanda �� Notary Public Slate of Flodda
Mdiea Lam6eM1 Andrea Lambert
8evised 09/15/1 i' y commission GG 194517 M Commission GG 164517
• I- - we� Expi es 02120/z022 -• � F fires 02/z0/2022
I
II
II
y
I
I
I
II ,
�ttP