HomeMy WebLinkAboutChange of Contractor 01/01/1999 00:02 15084959989 PAPAW PAGE 01
�I ISI PLANNING & DEVELOPMENT SERVICES
BUILDING&ZONING DIVISION
2300 VIRGINIA AVE
FORT PIERCE,FL 34982
(772) 462-1553 FAX 462-1578
MANGE OF CONTRACTOR.SUBCONTRACTOR OR C,AMELLATION OF PERT
ELF,ASE SE ECT ONE OE THE FOLLOWIN01,
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 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.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 loom. There is a$50.00 fee for the Change of Sub-
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ctor.
CANCELLATION OF PERMIT—The cancellation of a po nit is acceptable only if no work has been done.
ation of permit is to be sigaed and notarized by both the owner and qualifier of record. There is no� feefor
cancellation of the permit. 6�,�,•1Z lvrr VAUN�ICON11 3h(tc�s owe' C6n -,.cs . / r�
Date: � / /tP�
/ � C flW� S't'atr}>�ermit Number: 1 gJ '
Site Address: /e?a /V1 zm e—
G1
Original GC,subcontractor or owner/builder
State Licease_, __SLC License
New GC,subcontractor
Reason for Cancellation
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,wbich may arise as a result of this change of
contractor/subcontractor or cancellation of pertnit.A permit cannot be cancelled if work has been performed.
SIGNA7 OF OWNER(or ov medbiudder) SIGNATURE GENERAL CONTRACTOR(ornew GC,as applicable)
PRINT NAME MOA)4 p U � PRINT NAME
_r744 k State of Florida,County of St Lucie County
�tateoFfl
The following insttumeat was acimowlcW before me this The following i,&=ent vm acknowledged before roe this
,L�L day oC 4nL2�,20ZMI,by day of_,20—,by
who is PM=AflY 1mown to un who is personally known to
or as ID. me or who has produced-83�•
S ~ L !Ll4i
Slptatme of NBtary Si ptature of Notary 09te
Revised 04/15/16
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