Change of General Contractor


City of Lake Mary Community Development-Building Division
911 WALLACE COURT LAKE MARY FLORIDA PHONE
(407) 585-1362/1360     FAX (407) 585-1346

 

CHANGE OF GENERAL CONTRACTOR

A NEW BUILDING PERMIT APPLICATION IS REQUIRED FOR A CHANGE OF CONTRACTOR. A NEW RECORDED NOTICE OF COMMENCEMENT IS REQUIRED FOR SUBMITTAL ALONG WITH THIS FORM.

Date________________ Fee: $25.00 Permit #_____________
 
Property Address_____________________________________________________________
I, _______________________________________, as owner of the above referenced property,
request that permit number _____________issued to __________________________________
be reissued to _________________________________________________________________.
 
I agree to hold City of Lake Mary Building Division harmless and relieve it from any
responsibility or liability for any legal action or damage resulting from the change of
contractor.
 
I will comply with Chapter 713, Florida Statutes (Mechanics Lien). I further assume
responsibility for corrections, if required, or work performed under the first permit.
 
Owner certifies they own plan associated with this permit.

Owner Signature ______________________________________________________________

Print Owner’s Name ___________________________________________________________

New Contractor’s Name/Title____________________________________________________

New Contractor’s Phone Number (s)_______________________________________________

STATE OF FLORIDA
COUNTY OF
____________________

The foregoing instrument was acknowledged before me this ____day of
________________, 20___, by ______________________________, who is [   ] personally known
to me; or [   ] who has produced _______________________as identification.

_________________________________
Signature of Notary Public
 
(Seal)