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HomeMy WebLinkAboutCHANGE OF CONTRACTORPLANNING & DEVELOPMENT SERkjC �,' fJP BUILDING & ZONING DIVISION 2300 VIRGINIA AVE FORT PIERCE, FL 34982 (772) 462-1553 FAX 462-1578 JUiN232016 PEMAITTiNG St. Lucie County, FL St. Lucie County CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMT PLEASE SELECT ONE OF THE FOLLOWING: X 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 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 cancellation of the permit. Date: 5/6/2015 Site Address: 3100 N. A1A Fort Pierce FL 34949 Permit Number: Uu- IDLH(O J.Crompton Electric, Inc. State License CGC1504970 SLC License Original GC, subcontractor or owner/builder JoWP.0 1d11Ylmltil;PG�0A S'ef4:CeS LIV State LicenseCGC/$1i�SLC License 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 of this change of contractor/subcontractor or cancellation of permit. A permit cannot be cancelled if w 1 For SiGNAT'UR ER (o r ownat'/buer) RE GENE O CTOR (or new GC, as applicable) PRINT NAMES in1r15—iCl PRINTNAM �r State of Florida, County of St. Lucie County The following instrument was acknowledgedbfore me ns e a�//,, ((�� day of_,�i „20��1x , by who isrersonallY known to me or who has produced as ID. g�ure of Notary Date Rev �Einrtsitoi%k`PF_f`��t � State of Florida, County of St. Lucie County me me TAmmN G. BAKER Notary Public - State of Florida My Comm. Expires Feb 12, 2017 commission # EE 847470 Banded Through National Notary Assn.