HomeMy WebLinkAboutCHANGE OF CONTRACTORPLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION RECEIVED
2300 VIRGINIA AVE SCANNED FEB 1 2 7019
FORT PIERCE, FL 34982 BY
(772) 462-1553 FAX 462-1578 St. Lucie County permitting Department
Sr. Lucie County
CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMT
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
c encmg 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: t-fb 12 , 71) G
Permit Number: `l `. 11 i 2 C)s Z�1
Site Address: E 3U2 q 2 I n d y 1 n Ed T-1rjYt 12 fYfYCQ l +L
C''IIe V)n IE�1fCATil, State License SLC License
Original GC, subcontractor o wner/bu'Ider
taV_1-nC-`vU_)`6r
C— 1`wi Vl yai S-Q1" iVV1 C2& State LicenseJEQ%IQ%41_1 SLC License 3) a 0
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 arising from any and all claims of action for any reason, which may arise as a result of this change of
contractol7subcontractpr or cancellation of permit. A permit cannot be cancelled if work has been performed.
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State of Florida, County of St. Lucie County
Revised 04/1
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