HomeMy WebLinkAboutMisc Letters PLANNING & DEVELOPMENT SERVICESEC ���
BUILDING & ZONING DIVISION `
2300 VIRGINIA AVE
• � _ AUN,/9p
12 1016
: .........__....,.....,.. ..... FORT PIERCE, FL 34982
(772) 462-1553 FAX 4624578
CHANGE OF CONTRACTOR,SUBCONTRACTOR OR CANCELLATION OF PERMT
PLEASE SELECT QNE OF THE FOLLOWINCr:
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 jobi 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$50.00 fee for the Change of Contractor.
CHANGE OF SUBCONTRACTOR-Subcontractor changes are to be completed by the general contractor.
The new subcontractor:must fill out a Subcontractor Agreement Forret. There is a S50.00 fee for the Change of Sub-
Co tractor.
CANCELLATION OF)PERMIT-The cancellation of a permit is acceptable only if no work has been done.
ancellation of permit is to be signed and notarized by both the owner and qualifier of record, There is no fee for
cancellation of the permit.
1
Date: i_ I -1 _ Permit Number:
Site Address: A2,7iQ 01 A(IL 2 6 —
cm State License cyc03-L-LP1.SLC License r
Original(GC,subcontractor or owner/builder
State License SLC License
New GC,subcontractor I&M GYL
Reason for Cancellation G D KI
The undersigned does hereby agree to indemnify and hold harmless St Lucie County,its officers,agents and employees from all
costs,fees or damages arising from any and all claims of action for any reason,which may arise as a result of this change of
contractor/subcontractor or cancellation of permit.A permit cannot be can lled if work has been performed.
51GNATURS OF OWNER(or owner/builder) SIGNATURE UFNI=RAL CONNrT>�CTOR(or new GC,as applicable)
PRINT NPIXIE PRINTNAME_
State of Florida,County of St Lucie County State of Florida,County of St.Lucie County
The following instrument was acknowledged before me this Ilowin i trument aeh °wled efor m this
day of 20,.E by day of�2tQ by�L Y1�01 J1
who is personally known to me io is personalty kn to
or who has produced-as ID. me or h has produc as 1 .
Signature of Notary Date gnatur �..+•I(A ,�V
DANELL9 M WE
`? my COMMISSION#FFOSU58
Revised 09/2,5/16 EXPIRE$Fabnearll t6,2020
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