HomeMy WebLinkAboutCHANGE OF CONTRACTORPLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION
2300 VIRGINIA AVE SCANNED
BY
FORT PIERCE, FL 34982
St. Lucie
Count
(772)462-1553 FAX 462-1578
CHANGE OF CONTRACTOR SUBCONTRACTOR OR CANCELLATION OF PERNPI'
PLEASE SELECT ONE OF THE FOLLOWING:
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 PERbHT - 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-�- 31-/ S,
Site
Permit Number: ,1 I �_ GAI
License SLC License
Original GC, subcontractor or owneribuilder n �".
Si5re2 elaaUe Al '��[ R71�i �/CAS State License �-C� T SLC License 2? 5! Z-
New GC, subcontractor Pic.
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 r52 o ,which may anse as a result of this change of
contr44odsubcontraS4 or cancellation of permit. A permit cannot b can lied if w,aKhXbeen performed.
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State of Florida, County of St Lucie County
ne following instrument was acknowledged
is personally known to me
Date
GC, as
State of Florida, County of SL Lucie County
The following instrument was acl�oyvledged fore me this
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to as ID.
ofNomry Date
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