HomeMy WebLinkAboutCHENGE OF CONTRACTORN
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PLANNING & DEVELOPMENT S
BUILDING & ZONING DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578
MAR 3 0 2018
ST. Lucie County, pern
SCAT ANGE OF CONTRACTOR. SUBCONTRACTOR OR CANCELLATION OF PERMT
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StPLtsdP S E�++ PMONE 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 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: 3/2/2018
Pecmd Number•
Site Address: 605 Kimerman Road, Port St. Lucie, FL 34981
P.B. Brown, LLC State License CGC 1259288 SLC License
Original GC, subcontractor or owner/builder
Welsh Construction, LLC State License CGC 041824 SLC License
New GC; subcontractor
Reason for Cancellation
The and oes hereby agree to indemnify and hold, harmless Sr Lucie County, its officers, agents and employees from
costs, fee or ges arising from my and all claims of action for any reason, which may arise as a result of this change of
contract r/subc ctor or cancellation of permit A permit cannot be caqglkf iPy19rk,)ias beemperformed.
SIGNATURE OF/)WNER (or ownerlbuilder) SIGNArireE GENERAL CONTRACTOR (or new GC, as applicable)
PRINT
State of Florida, County of St. Lurie County
The following instrument was acknowledged before me this
dayoC fits .20i0 by
who is penunslly known to me
r who pnduc f (1a &A as in.
312/2018
Signature of ry Date
PRINT NAME KR Welsh
State of Florida, County of SL Lucie County
The following instrument was oclmowlodged before me this
3 day of MAKGt/ .20J.&by
k iL W t(g �L who is oemooally known to
St7whohasprod at to.,r Y3/2Y2018
/Signature of Notary Date
T. STARNESoartono Loibrock NOTARY PUBLICrevised 09/m5/16 Nousry PubmoSTATE T, TARFLONESStKn Of Nvw YorkDA
County Of Greens CommkFF156229
Commission Expires: 041201 t*SON,A
Empires 12127/2018
No. 01Ee40H70.1