HomeMy WebLinkAboutCHANGE OF CONTRACTOR`PL'ANN_INC;r& DEYE_LOPMENT SERVICES.
" RUILDING &ZONING_ iDIVISION
23.00IV_IR_GINIA AVE
FORE IERCE;,FL 34982
(772)462=1553 fAX 462-1578
CHANGE'OF CONTRACTOR. SUBCONTRACTOR' OR CANCELLATION OF PERMT
PLEASE SELECTONE OF THE FOLLOWING:
CHANGE OF CONTRACTOR —Change of Contractor is to be signed and notarized by the property owner,
and thew contractor of record for the current pef riit.'A new permit application must also be completed with new
contractor Inforriiation and signature. A new Notice of Commencement must be!, filed -".,the new contractor's name,
for job values greater than S2,560 (S7,500 if A/C Change -out). A recorded copy _m`ust ,be submitted prior' in
commencing any work There is dS50.00 fee hi the Change of Contractor.
CHANGE OF SUBCONTRACTOR-- Subcontractorchanges are to be completed by the general contractor.
The new subcontractor must fill out a Subcontractor Agreement Form There is a SS6.00_fee for,the Change of Sub -
Contractor.
CANCELLATION OF PERT IT The cancellation of a permit is acceptable only if no work has been done.
Cancellation of`perrrtit`is to bosigned and notarized by both the owner and qualifier.of record. There.is no fee for
cancellation of the permit:
Date: JULY 2, 2019
Permit Number: 1610.0042
Site Address: .6600 S OCEAN DR. PH2
GM CONSTRUCTION LLC . ° State License CGCO49743 SLC License
Original GC, subcontractor or owner/builder
-- -WA State License SLC License
New GC, subcontractor
for
TERMINATED DUE TO
t me unaersignea noes nereoy agree to maernmry ano noia nartntes!
costs, fees or damages arising from any and all claims of action for
contractor/subcontractor -or cancellation of permit. A permit cannf
SIGNATURE OF OWNER (or owaedbuilder)
PRINT NAME
State of Florida. County of SL Lucie County
The following instrument was ackioWedged berm me this
day of 20_, by
who is personally lu msn to ran
or who has produced as in.
— _ JULY 2, 2019 -
SlgnatareofNotary Date
Revised 04/15/16 SCANNED
BY
81. Lucie County
1➢LIu1
PAY
its officers; agents and employees fron
may arise`as a result of this chance cif
State orFtorida, County orSL Lucie County
The fa towing hi - t was ac{ tt*edged before me this
yor' 20 by-
who is pommsIly Imown to
me or why has pmduwl ns in.