HomeMy WebLinkAboutMisc Letters OCT-16-2015 FRI 01 : 51 PM CENTp'd1. SCHEDULING FAX No. 321268�.1`?9 P. 001
D
Planning&Development Services OCT 162015
• �C - Building&Cade Regulations Division
�. 2300 Virginia Ave. —'—I a A
Fort Pierce,FL 34982 d d
(772)462-1553 Fax 462-1578
CHANGE OF NTRAC Ii V 0%
Or Subcontractor o Cane lation of Permit --
aoo - 5
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; 1 o I ILP) 1� Permit dumber: I .51b~ �)2�0Z
Site Addres '-'tgl N 'C lJ� C '�';�� 1 .
State Licensb• PC_Ab_ l.'tL� ,C License
Original General Contractor(or Subcontractor)
State License SLC License
New Genual Contractor(or Subcontractor) 1;`ryl
Reason for Change l '(�
1
The undersigned does hereby agree to indemnify and hold harmless St.Lucile 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. A permit cannot be cancelled if work has been performed.
sio RE OF 0 (or ownerlbuilder) 1��p(�1
PRIe 'nNT NAMVqLUeft: " SIGNATURE OF NEW GENERAL CONTRACTOR
e 1 lSli`k.+ PRINTNAD45
State of Florida,County of St.Lucie County State of Florida,County of St.Lucie County
AMRledged before me this Tate follawmi g instrrupent.was acknowledged before me thus
by day of 20_,by
personally lmow to me wbo is personally know to me
or o ba rodueed as ID. or who bas produced as ID.
Si atuYe of Notary Aate Signature of Notary Date
*Only signature required for change of subcontractor
Revised 07/21/19 ;r, ;Yp Catherine KCngez•
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% 7.! z P- fres:OCT 28,2018
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