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PLANNING & DEVELOPMENT SERVICES eat s<Kv90 "�o
BUILDING & ZONING DIVISION
2300 VIRGINIA AVE SCANNED
FORT PIERCE, FL 34982 BY
(772) 462-1553 FAX 462-1578 St. Lucie County
CHANGE OF CONTRACTOR SUBCONTRACTOR OR CANCELLATION OF PERMT
PLEASE SELECT ONE OF THE FOLLOWING:
X 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 Sled 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: 1/9/20
Site Address: 4946 S 25th Street
Permit Number: 1902-0085
Venture Construction Services, Inc State License CGC 009286 LC License
Original GC, subcontractor or owner/builder
Rossco Construction Services, Inc. state License CGC 050957
SLC License
New GC, subcontractor
County requires GC to be named at timeAermit prior to plans goinq� out to bid.
iteasoIIterCancelletion w..._. __way_ ___e__u..__ _w _s__� _..
me 1111a0IalgIIea hemby ag[ce to indemnify and hold harmless St LuciZilef,
, its ffiars, agents and employees from
costs fees from any and all claims of action for any masmice as a result ofthis change of
connector/subco arhancelletion ofpemdt. A permit cannot be can wo has been performed.
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Christine Fritz
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