HomeMy WebLinkAboutCHANGE OF SUBCONTRACTORPlanning & Development Services=RECEEIVEDBuilding & Code Regulations DivisionZ300VirginiaAve. Fort Pierce, FL 34982(772)462-1553 Fax 462-1578
OF CONTRACTOR SCANNED
Subcontractor Cancellation of Permit BY
Change of Contractor is to be completed b the roe contractor
Lucie record
for t
g p y property riy owner, and the new contractor of record for the
current permit. A new permit application must also be completed with new contractor information,
signature, and transfer fee. A new Notice of Commencement must be fled in the new contractor's
name for job values greater than $2,500 ($7,500 if A/C Change -out). A recorded copy must be
submitted prior to commencing any work. Subcontractor changes can be completed by the general
contractor. Absent extenuating ei ctunstances, a cancellation of permit is to be executed by both the
owner and qualifier of record.
Date: /q/ /61 / g Permit Number: 1966 - 0/2-5
Site Address:
W
U : ! In m t3 ii G AJS_ rt )O/`I 3� State License Z 3G` 8 y SLC License ?�
Original General Contractor ( r Subcontractor
e�Se UC_ CMG Ig�oGO$
a State License SLC License
New Gen rat Contract r or Subcontractor
Reason for Change Qr>q:uaA om6-&Ckor Lw (2e�oNslUt
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 of this change of contractor/su ctor or cancellation of
permit. A permit cannot be cancelled if work has been performed
1:17f�Fil
State of Florida, Cmmly of St. Lucie County
The following instrument was acknowledged before t`ne this
`� day of dti ,201A,by b %J1`�l
A O n ht who is personally know to me
r who has produce r- as in.
toed
Signature of Notary Date
PRiNTNAME ✓.a" c. /:1e2�-tf--
Stale of Florida, County of St. Lucie County
The following instrument was acknowledged before me this
dayof0_, 20,4 by �r
W Q.Q$ 0— who is personally know to me
or has produced as ID.
--r—
Signature o tort' Date
` hange of subcontractor
;q{n;4c, DFANNAh IE GI NS P
R €qe y r /%COMtAISSION P GG 022023
. gg PIRES: December 16.2020 .
'PFP�o' Bonded Thm Notary Public UndenvdtaR
Notary Pudic Slat. of Florid.
Amy N Wood
ar MyCemml.een GG 241664
EaPires 072512022