HomeMy WebLinkAboutCHANGE OF CONTRACTOR�r.
SCANNED '
BY
St. Lucie County
Planning & Development Services
Building & Code Regulations Division
2300 Virginia Ave.
Fort Pierce, FL 34982
(772 46 - 3 Fex-0
RANGE OF
Or Subcon ra ancellation of Permit
RECEIVED
FEB 2 5 2019
L
cie County, PE3rinitting
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: l �) r Iz13(2-0 t 1) Permit Number: 1801-0311
Site Address: t er \ � 5) Ne2 k- \DLm \') C"\ I �C-%3c\1 L 'Jc�570
State License V L SLC License
Original General Contractor (or Subcontractor)
f)V-e,0e' s tyk �vz_ State License SLC License
New General Contractor (or Subcontractor)
4-
Reason for Change t` ( "c
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 contr r/subcontractoyl6rancellation of
pe it. A permit cannot be cancelledif
work has been perforffie
SI NAT RE OF OWNER (or-owner/builder) • SIGNATURE OF- m-' GENERA, CO>;I�RACTOR ,
PRINT NAME Stephen I. Smoak and Gina R. Smoak
State of IAe»da, Cow owty o SF-L-uc c2o�
The following instrument was acknowledged before me this
day of 201Q, by k. oak
Q who is personally know to me
Signature ofNofar�AZV _m{lllkp� ^=9 i
O
oTA&I
*Only sign=tgr��rtquiit4 fct {
C')
Revised 07/21*;,,f
17 20�'
�'�s�URGt eGJ,•'`
PRINT NAM
State of Florida, County of St. Lucie County
The following instrmtent was acknowledged before me this
_day of 20_ by
is personally know to me
or who has produced as ID.
Signature of Notary
of subcontractor
Date