HomeMy WebLinkAboutCANCELLATION OF PERMITPLANNING: & DEVKLOPMENT SERVICES
BUILDING & WNING; DIVISION
2300 VIRG:INIA AVE SGANNU)
FORTNERCE, F1.34982 BY
(772) 462-1553 FAX 462-1578 St. Lucie Counfv
C111ANC K M7 CONTRAC-1'Olt, SIIIICONTItACPOR OR CANCELLATION OF PERMT
11I:A51;,gJUCL' ONU1'_RIL' EOLLt1W10!
CIIANGE OR CONTRACrOPt — Change of Contractor is to be signed and notarized by the property owner,
unit 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 -Nut). A recorded copy must be submitted prior to
commencing any work. There I.s a $50.00 fee for the Change or Contractor.
CIIANC:I-. OF SUBCONTRACTOR — Subconlmclor 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 orsub-
nlrnc'or
.
CANCELLATION OE PERMIT — •ilie cancellation of a permit is acceptable only if no work has been done.
gncollation of punnil is to be signed and notarised by both the owner and qualifier of record. There is no fee for
cancellation of file permit.
Dale: 3� II permit Number:
S // : eC/, Site Address: 2 'r ULI
/ //
/� /arr:sa.n SC[ Slate License /?//S/C) LC License
Original GC, subcontractor or owner/builder
/ 4,� �/ L � State License9r- 13/1570// SLC License
New GC, subcontractor
Reason for Cancellation
Tile undersigned does hereby agree to indemnify and hold harmless St Lucie County, its oRcers, agents and employees fron
costs, fees or damages arising from any and all claims of action for any reason, which may arise as a result of this change of
contractor/subcontractor or cancellation of permit. A permit cannot be cancelled If w it lr- can pe ormed.
SIGNATURE OF OWNER(orownedbuildco SIGNATURE. GE AL RACTOR Cur new GC, as applicable)
PRINT NAME i'IUN7'NAb
statoorFlarhla.CouRlyofSL LualeCounly, Sate of Florida. County of St. l.ucie County
The following instrument wasaeknoxlWged before me this The allowing inst eat wit lodged before me this
_goy of 20_, by ay of 20 by
wfio is peronally kriqun to me r .._.. 1 QXII - xho is rsonally known to
a Wall has produced as 11). WONM
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7 LQ/�SlgnaluredNaury,, Due DateRavlend 0d/1S/16Be Slab orFbrlda Flynnaelon GG 1ga76J
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