Fillable CHANGE OF CONTRACTOR NOT WILLING (INSTRUCTION SHEET) From (Seminole County Government)

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CHANGE OF CONTRACTOR NOT WILLING (INSTRUCTION SHEET) From (Seminole County Government)

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___________________________________________________________
___________________________________________________________
Revised 3/10/20
Building Division
CHANGE OF CONTRACTOR
(INSTRUCTION SHEET)
From General Contractor to Owner-Builder
NOT WILLING
Use this packet if the General Contractor is NOT WILLING to provide a letter of withdrawal.
DOCUMENTS REQUIRED:
1. WORK PERMIT APPLICATION Signed By Property Owner – As Owner-Builder
CHANGE OF CONTRACTOR HOLD HARMLESS FORM
Signed and notarized by the Owner on both pages
2. Letter from the Property Owner to the existing contractor of record notifying him that he
has been terminated from the job. A copy of the letter along with proof that the contractor
received this letter, either via-certified return receipt, courier, hand- delivered, etc., must be
provided to the Building Department.
3. A new notice of commencement is required for submittal along with this form
Change of Contractor transferring permit
FROM:
General Contractor who has left the job and is NOT willing to provide a letter.
TO:
Property owner who will take over the permit as an OWNER-BUILDER
1101 EAST FIRST STREET SANFORD FL 32771-1468 PHONE (407) 665-7050 FAX (407) 665-7486
bpcustomerservice@semiolecountyfl.gov
_________________________________ _____________________________________
___________________________________
_____________________________________ _____________________________
_____________________________________
FROM PROPERTY OWNER TO GENERAL CONTRACTOR
DATE: ______________
Contractor: _______________________________
ATTN: Qualifier: ______________________________
Address: ______________________________________________________________
I, ___________________________, property owner of _____________________________________
(address), am notifying you that your services are hereby terminated from our project / permit number
_____________.
You are being terminated because:
Owner's Signature Printed Name
You are no longer authorized to come onto my property.
STATE OF FLORIDA
COUNTY OF _______________
Sworn to and subscribed before me by means of [ ] physical presence or [ ] online
notarization, this _____ day of ________________, 20___ by: ________________________
(name of person acknowledging), who is [ ] personally known to me; or [ ] has produced
__________________________ as identification.
Signature of Notary Public (Seal)
If the letter is going to be hand-delivered to the General Contractor, the General Contractor
needs to fill out below.
Received by: Signature Date
Printed Name
_________________________________________
Change of Contractor Hold Harmless
Re: Property located at _________________________________________
To whom it may concern: A legal owner of subject property, I request a change of contractor for
permit number __________ issued to ________________________________ (name of previous
permit holder) whose mailing address is ___________________________________. The permit was
issued on __________ (date permit was issued). I am requesting a change of contractor for the
following reason:
I no longer authorize the previous permit holder to proceed with the work covered by the
permit.
By signing below, the owner certifies they own the permitted plans.
I hereby apply as Owner-Builder [F. S. 489.103(7) as defined].
I, the Property Owner acting as my own contractor as an OWNER-BUILDER, agree to hold the
SEMINOLE COUNTY Building Division, its agents and authorized personnel, harmless and
relieve them from any responsibility or liability for any legal action or damage, cost or expense
(including attorney's fee) resulting from the Change of Contractor on the existing permit. I
further assume responsibility for the entire scope of the permitted work; specifically all work
completed and work to be completed. I assume responsibility for the correction, if required, of
work performed under the permit for which I am requesting a change of contractor. If there has
been a change of ownership on the property, the new owner assumes responsibility of
notifying the previous owner of his or her intent to transfer the permit.
Owner's Signature: ______________________________________
The person, whose signature is above, deposes that he/she is the owner above property,
STATE OF FLORIDA
COUNTY OF _______________
Sworn to and subscribed before me by means of [ ] physical presence or [ ] online notarization, this
______ day of _____________________, 20____ by: _____________________________________
who is [ ] personally known to me; or [ ] who has produced _______________________________
as identification.
Signature of Notary Public (Seal)
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CHANGE OF CONTRACTOR NOT WILLING (INSTRUCTION SHEET) From (Seminole County Government)

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Completed 6 August 2020

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