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Home My WebLink AboutCHANGE OF CONTRACTORPlanning & Development Services Building & Code Regulations Division 2300 Virginia Ave. SCANNED Fort Pierce, FL 34982 BY (772)462-1553 Fax 462-1578 St. Lucie Count, CHANGE CONTRACTOR Or Subcontrac lcellation of Permit Change of Contractor is to be completed 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, signature, and transfer fee. 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. Subcontractor changes can be completed by the general contractor. Absent extenuating circumstances, a cancellation of permit is to be executed by both the owner and qualifier of record. Date: i — i I — ) Original Contractor (or Subcontractor) New General Contractor (or Subcontractor) Reason for Change 6LYT OF P.kDKY1,Y Permit Number: i SD S - 033 I LicenseC�6`_ SLC License License SLC License 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/subcontractor or cancellation of permit. A permit cannot be cancelled if work has been performed. SIGNATURE OF OWNER (or owner/builder) PRINT NAME State of Florida, County of St. Lucie County The following instrument was acknowledged before me this _day of 20_ by is personally know to me or who has produced as ID. Signature of Notary Date • SIGNATURE OF NEW GENERAL CONTRACTOR PRINT NAME State of Florida, County of St. Lucie County The following instrument was acknowledged before me this _day of 20� by is personally know to me or who has produced as ID. Signature of Notary Date *Only signature required for change of subcontractor Revised 07/21/14 Planning & Development Services RECEI V�p Building & Code Regulations Division BAN 2 51016 2300 Virginia Ave. Fort Pierce, FL 34982 (772)462-1553 Fax 462-1578 SCANNED BY CHANGE OF CONTRACTOR St. Lucie Count, Or subcontractor or cancellation of permit Change of Contractor is to be completed 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, signature, and transfer fee. A new Notice of commencement must be filed in the new contractor's name for job value's 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. Any cancellation of permit must be executed by the owner or qualifier of record. Date: I/raIIrs Permit Number: 5/-C - I3-03-033, Site Address: ff7o5- S _s. L 19orl Sa• �'I� on Lanl[ea d /d•a r oAlnl4r uc State License SLC License Original General Contractor (or Subcontractor) IPcww�m �A,F xnei.+l .l,w />+s State License CGe I S7`�SLC License New General Contractor (or Subcontractor) Reason for Change M4 T4 I S2 /r4 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/subcontractor or cancellation of permit. SIGNATURE OWNER (or owner/builder) PRINT NAME ✓mil �/�� State of Florida, County of St. Lucie County was acknowledged before me this 201 � by _who is personally know to me • siGNATME OF NE�wwJ�GENERAL CONTRACTOR PRINT NAME L/�. State of of Florida, County of St. Lucie County Signature *Only signature required for change of subcontractor COLLEEN SUE HAYES Conan iss ion 0 FF 200728 - ®^ca My Commission Enpuos .....0 March 15, 2019 acknowledged before me this is personally know to me COLLEEN SUE HAYES Commission a FF 208728 My Commission Expnos !'n`"' March 15, 2019 Planning & Development Services Building& Code Regulations Division $C 2300 Virginia Ave ANNE6 Fort Pierce, FL 34982 S't By (772)462-1553 Fax 462-1578 tucie Coarq. CHANGE OF CONTRACTOR Or Subcontractor or Cancellation of Permit Change of Contractor is to be completed 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, signature, and transfer fee_ 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. Subcontractor changes can be completed by the general contractor. Absent extenuating circumstances, a cancellation ot,permit is to be executed by both the owner and qualifier of record, Date -IVA& ki 20ts S1teAddress: Permit Number: k503 -D331 ��el. 1. Ga�N>✓��i� FS��t�E State License SLC License Original General Contractor (or sutxbntractor) �nRDne1 �►.��t�sl�uuH►JL CAitkLINQateLicenseCF�Ll7S2851SL-Cticense New General Contractor (or Subcontractor) Reason for Change Ytracr,- -The undersigned does hereby agree to indemnify and hold harmless St. Lucie County, its officers, agents, and employees from al I costs, fees, or damages arisi ng from any and al I d ai ms of action for any -reason, which may -arise as a result -of this change of contractor/subcontractor or cancel Iat! on of per?) A permit cannot becancelledif work hasbeen performed. �7 SIGNATURE OF OWN or_owner/bUdd ) _ • S1GNAftfRF OF 14EW GENERAL CONTRACTOR PRINT NAME Urp PRI A - �jpTLL1bI.] �V_U/J 1 Z le/0 f lal 51 ao7 0 Rate of Florida County of R. LudeConty Sate of Florida, Caurdy of R. Lude County Thefdlowi"ims u wasadm eelgAei before rrethis Thefolloving insimmed wasadmovledged before methis day 2g by \�!.\)P Malay cf-..i,'C 20_Cby Zo who ispersonally knoN to me who is personally know to me orwhotEs K$f as to. orw uoed \ aslD. -i7-is,-�� G-c7- c S Signature of Notary Date Sgnature of Notary at�Pl e *Only signature required for change of subcontractor Revised 07/21/14 NICOLASA CRESPO `e My COMMISSION N EE171214 EXPIRES F®blu0y 20,201E �eotst e+�° eem