HomeMy WebLinkAbout12-0862 304 Blue Lakes Blvd Change of Contractor 12/09/2014 12:53 5415640847 H R BLOCK PAGE 01/01
RECEIVED
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DEC 0 9 Z014
CITY OF TWIN FALLS
BUILDING DEPT.
SCRVtt�a
P.O. Box 1907 324 Hansen Street East Twin Falls,Idaho 83303-1907 Fax:(208)736-2256
OFFICE OF T.GI'F BUILDING DE'PA RTMP'NT 208.-735-7288
Changing of Contractor Procedure
Owner or Authorized Agent
Please read entire document before signing.
* Existing permit will be closed.A new permit is required for work to proceed further. No
additional fees unless additional work above previous permit is to be done. Fees paid will be
transferred to new permit. �)) P
Person making Request(please print) G l�l./,>yl ' �—f<<
Project naitite Q�( 13 �L!,K—address L6 Permit number_
Name of Owner ! �l �re r rcL r 1 l Phone 9q/-7 2- -q -g
Name of existing contractor Phone
• Owner or authorized agent making request is responsible to notify all parties involved of intent
to close existing permit.
• Owner,contractor, or authorized agent to completely fill out,sign and submit the executed
Change of Contractor Form.
Fees will not be refunded on canceled permits.All work will cease on canceled permit.Work may
resume after new permit has been issued. Fees paid will be transferred to new permit.
Signatures below signify that the City of Twin Falls is held harmless from any legal involvement
regd-edfng thrs request. 13dtK outitler and new contMtOr are regUifed to sign.— -
Signature of owner or authorized agent --
Signature of new contractor_: ��. r' date
(Office use only) reference permits 4