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HomeMy WebLinkAboutCHANGE OF CONTRACTORPlanning & Development Services CC// Building & Code Regulations Division 'C U N� ' 2300 Virginia Ave. Fort Pierce, FL 34982 (772)462-1553 Fax462-1578 SCANNED BY CHANGE OF CONTRACTOR St. Lucie County Or subcontractor or cancellation of permit 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 Sled in the new contractor's name for job value's 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. Any cancellation of permit must be executed by the owner or qualifier of record. Date: ©H — j g r / �— Permit Number: Site Address: Ll� _Ala E / 1/�'� /2 r ��/ Az / � 7-6LI CC) /.i r� _State License SLC License Original General Contractor (or Subcontractor) New General Contractor (or Subcontractor)State License SLC License Reason for Change 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. SIGKATM OF OWNER (orowner/builder) PRINT NAME 6- At State of Florida, County of St Lucie County ' SIGNATURE OF NEW GENERAL CONTRACTOR PRINT NAME State of Florida, County of St Lucie County The following instrument was acknowledged before me this %-[R—aay pLc_r1J�_, 201,1 by _day of .20� !P who is personally ]mow to me who is personailykaow to me o °� as ID. or who Iias produced as ID. Signature of Notary Date Signature of Notary Date *Only signature required for change of subcontractor "'9a'•. LASHAHNAINGRAM i° `�; Notary Public - State of Florida ! My Comm. Expires Doc 20. 2018 =;;�O�ec' Commission N FF, 177249 '"`�����"` Sonded through Nahonal:tary Assn