HomeMy WebLinkAboutChange of Sub-Contractor - Electrical PLANNING & DEVELOPMENT SERVICES
s, J, BUILDING & ZONING DIVISION
0 �41,21v 2300 VIRGINIA AVE
F ORT P1 ERCE, FL 34982
(772) 462-1553 FAX 462-1578
CHANGE OF CONTRACTOR. SUBCONTRACTOR OR CANCELLATION OF PERMIT
PL AS[_ SLLCC"[ 0LNL ()J, (iL I-t� )L1-QV+'INCi:
CIJANGE OF CONTRACTOR--Change of Cotltt'actor is to be signed and notarized by the property owner.
and the new contras ioi-of-ie oid tot the cu►-rent permii, A new permit application must also be completed %,ith new
contractor information tend signatuic A new Notice. of Commencement rr wm be filed in the now contractor's name
for job %attics greater (hay) $2,500 (57.500 if A/C Change-out) ,A recorded copy inust be submitted prior to
commencing any Notk.Thera is a S50.00 fee for Me Change of Contractor.
}C C:1'IANGE 01. SUBCON I RAC(0I2 -- Subcontractor changes are to be completed h�- the general contractoi.
The nexv subcontraetor moat till out a Subcor.tuictor Agreement form. There is a S50.00 fee for the Change of Sub-
Contractor.
_ C-ANC'Et.(_YI ION OF Ir IGN41 i' llh;•c,mccflarion of.t perm-t, is accc-ptable only if no work het`heal dome:.
Cancellation Vf Peli)lit I. to be gipnell and rite -irized by both the o%%,nei and qualifiicr of ie(ord. '('here is no fee for
cancellation of the permit.
Date: _ _ ._ _ Permil Number:
State Lictmsc I CLJJ f�tpf C• f..ivelijc
Orlgimil GC,siibcomraetor or ox%fict.'i.)-iiWO, Le
-
' �►T ( Il( WQ1 _Slafc 1_tcen,e ��" �41 (` I.iccl►;c
New GC.suht tontl,iclor — —
Reason t'ur -
1 he t miusigned de)ci here b� avrec to iadmmi0y;loaf hold Sc Lkicie C'olttity,its officers.dgmts and cmplay(N-.3 From atl
Go3ty,rocs of dalluu? 86 1111,Cord)).tray tiIIJ III;i Ilflll$(IraC(i(kCk 12Qf at15,rca5(,11,%vhtth way.iitZri as:t rcC Ellt tit this chavig.of
cwon(t,t:,fit`sub._oft:iaL(4it or i<rnecilation o pe-itnt( A permit clumot ire..cllncol ed if►cork has hero performed.
.10U`ATLIXL01 UU':if:R(trlo il.bl)oAlo) 511G;`:�i fltECrE'�)fc f'f?\jrFiU,117R.for my*COL xcapp-",-ik4:
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t•r ad :17.11,P•odt: +'- _ -_ai fC) 1 0 r W�,11 rxCriJactd _ _ a-it)
sign irate or Nman• flair SignAlUM a(Notary Wit
,si ruoary
puoaC State or Fianna
o, by
PtvWry f U01'c State of Flor as r It, Hannah E Moore
Hannah E Moore r My:."-rtmisSion HP 01709S
r� My Commission HH o 17o9S '
E.n es07a1Q02a
'4'iaFd� Exves0710120ze '?ate
E
I. - IISSUE DATEL I
PLANNING & DEVELOPMENT SERVICES
■
Building& Code Compliance Division
-LINTY
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
Ehman Electrical Contractor,LLC y have agreed to be
(Company Name,Individual Name)
the__ Electrical _ Sub-contractor for Adams Homes of Northwest Florida, INC
('type of Trade) (Primary Contractor)
For the project located at 3! c �
(Project Street Address or Property Tax ID P)
It is understood that, if there is any change of status regarding our participation with the above mentioned
project,the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the
filing of a Change of Sub-contractor notice.
CONTRACTORSIGNATI'RE{Qualifieri St S.COYTRACTOR SIGNATURE(Qulitierl
W Bryan Adams Timothy L Ehman
PRINT 11A,►IE - — PRINT NAME
29179 _ 31748 _
COt'1T\'CERTIFKATION At'�IWLR� • COINXTY CERTIFICATION NtIMSER
slxle of Florida,Count%of St Lucie Starr of Florida,Cc1.r ry of ST LUCIE
The foregoing instrument s,as signed before me this 1.-day or The foregoing instrurneat was signed before me this f flat of
�th /y �sy W. Bryan Adams , Tlmoth L Ehman
who is personally known, or has produced a who is personally known Y_ or has produced■
as id li6ralion• as tdenlitica ton.
STANIP _ STAMP
Si xt o N r- u he Signewre of rVotary P bile
i
P I Name of i• rj Public \\\►11111fff /f� Print Name of Notary Public
Y e. p
aor's Notary Public State of Florldo 1
* ; r I Laura Townsend I
4111�0,0 M r_ My Commra3lon
Revised H.Ib:20Ili - 2 'v ' ' HH 175075
2•z OFYi 106177 ?orr�° Exp.4/1312025 3
iq y 4�#aQn6 ,`�°:•,�O``
STATE'
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