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Home My WebLink AboutCHANGE OF CONTRACTOR$I PLANNING & DEVELOPMENT SERVICES BUILDING & ZONING DIVISION 2300 VIRGINIA AVE FORT PIERCE, FL 34982 (772) 462-1553 FAX 462-1578 So St44uey�EO CO4071�z CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMT LEAS ELECT O O T O LO G: 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 commencing 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 PERNIIT — 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: -7.1 11 el Permit Number: ) of 0 5^ O c, 3Ct site Address: 5a35 C�ikland Lt^I C�rye1Ft =t ierce,FL- 3 `f95) R6onr�.Cdk 4—A-:R < State LicenseCAKLJOS 8-12SLCLicense o`7911 Original GC, subcontractor or owner/builder Sbct+t-aarmes +aber State License CGQ5I1157 SLCLicense New GC, subcontractor Reason for Cancellation The undersigned does hereby agree to indemnify and hold harmless St Lucie County, its officers, agents and employees from all costs, fees or damages arising from any and all claims of action for any reason, which May arise as a result ofthis change of contractor/subcontractor Or on ofperin A permit cannot be cancelled if rl 1t S been performed. SIG ATURE OF or owneribuilder) SIGNATURE GENE C/3/ACTOR(or new GC, as applicable) PRINT NAME iSe.l'T Tornlinsoh PRIIdTNAMB 3 FQbpr- State ofploride, County of St. Lucie County State of Florida, County of St Lucie County The following instrument was aftoowledged before me dds -L—t-day of 3�. 20 n s • by -e OOh 1=�fY1�jYl(it7y-� who is ersonelly kn to ma who has ( produce ID. -711 I 1g Signature of Notary Datc Revis Nolary Public Stale of Florida aY Andrea Lomb rt MY Commission GG 1a4517 F�tPrtea 02/2012022 The following instmmentwn aeknowledgttlbefare ethis _ 5Fdayof-(JT 20_oby SS Fabec who penonallykm e or who has prod ced as Signature of Notary Date �.Vv Notary Public Smle of Florida Andrea Lamben MY commission GG 184517 aaa°" XPlres ov2012022 3( PLANNING & DEVELOPMENT BUILDING & ZONING DMSIO 2300 VIRGINIA AVE FORT PIERCE, FL 34982 (772) 462-1553 FAX 462-1578 N RECEIVE® JUL 3 2019 Permitting Department St. Lucie County, FL PLEA LECT O OF THE FOLLOWING: St. Lucie COUI1tV CHANGE OF CONTRACTOR— Change of Contractor is to be signed and notarized by the props 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 commencing 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 $50.00 fee for the Change of Sub - Contractor. - CANCELLATION OF PERMIT — The cancellation of a permit is acceptable only if no work has been done. Cancellation of permit is to be signed and notarized by both the owner and qualifier of record. There is no fee for caneellation.of the permit. Date: 7/ 1h g Permit Number: ) q 05- - Q (O 8 L4 Site Address: 5 0 5$ C�iklQhd LLI Ci rcle f Pt ?i ercf , FL. 3 `f9 ) ^31�PC��YYiF�kyy U�CEG StateLicensec-IR78-11SLCLicense r?3911 Original GC, subcontractor or owner/builder Seg0+t_-Y0.rr)es Faber state License CGC(511)57SLCLicense�)\D,is New GC, subcontractor Reason for Cancellation The undersigned does hereby agree to indemnify and hold harmless St Lucie County, its officers, agents and employees from all costs, fees or damages arising from any and all claims of action for any reason, which nlay arise as a result of this change of contractor/su Znttactor or on ofpemdt A permit cannot be cancelled if r Aah been performed. SI ATURBGF 1, BRorowneribuilder) SIGNATURE G C CTOR(ornewGC, as applicable) PRINT NAME a;e°)An l i nsoh rRn-rrNAbdE,5c_c4+3ame.S Faber State of Florida, County of St Lucie County State of Florida, County of St Lucie County The following instrument was acknowledged before me this ,lySL- dayor I�dl�lrl`3ov�. whois ersotrelly tome J rwhohssP rodu as ID. _�11IIg Signature of Notary Date Revised O4/1 /1''Oo�µ6Nolary public State of Flonea Antlrea Lambert °� ,y My Commission GG 184517 ' Expires 02720/2022 The following insaumentwas aclaowleWbefom etiti9 r-5%F day of -( JT 20.� by S t Gooe-c whotpmoaa4y kne or who hes prod ced_ Signature of Notary Date ' Notary public Slate of Flonds s�. Andrea Lambert My commission GG `oi4c 184577 EV'res 02(20Y2022