HomeMy WebLinkAboutCHANGE OF CONTRACTORCOUNTY
F C v P. t D A--
NGE OF
PLANNING & DEVELOPMENT SERVICE S
BUILDIN
G & ZONING DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578
NC"'LLATION OF PERMT
PLEAI—U-1,_LE Q [f =) ' Tl
—CUANGF. OF CONTRACTOR — Change of Conitactor is to be wigned an(1 notarized b the
and the new conllactor ofrecold fur IhC currettl permit. A l,eH
coluractor information and Signahtrc. A nclA, Notice of COrnmencemcnt mmi be filed in the new con ttactolt cownel.
Permit application Ir1u5t also be completed wrth new
for fob +.-ahtes gresler than $2,St}0 (S?.SUU if .q�('
for
j lc'1tCt[l� Chiinge-out). A recorded cO ! Hato
any wot6. 7`hcr[ is a $50.00 fee for the Change of Conh'acrar. p} trlust be sultnlitted prior to
X�CIIANGE 01" %UBC0N1RAC-(-()JJ -- Snbcontrictorchartges asrr [o be cnntflleted by the rrencral
The n(w subcontractor mutt nil! ottt a Subcontractor Agr�ente.nt Form. There is a �50.00 fec for the Charno
Contractor. trJntrdctot.
,e of Suh-
CANCELLr l
�`flOt\ OI 1 T,12,1 17 the eanceilan'�rt of a isVrttt,t IS ac,cptabte only it n0 uurk has been (tone.
Cancellation Cf permit i. to be •Ipnrt9 ;1nt} rn�rlrt�ed be bl,lh tltz owner and (c-eptFicr of record. 'Dicke is c fee for
Date: _
Permit Number; _:,2v ,
�'-iJ -)
Site Address: -
����� -- ��G�•f�- _ - Orif;in:t1(A., subcontrttc.lor Stale License or tt,�r3cl built}cr L r r( Qp%-� l.0 License
Ne�v (�C', �tnc�ctnu:nck�r. �•� _Stale 1, icrn,,e ���
,SL(' Liccrt,t
Reason fur C'.ul.rllation
casts, fees or' darttagrS ariSrnn horn Ytny ,tni kll � l;trin lrtrf �(,ntf� anv rczvur� +�[ytY, i(S f ecri S i C as a of th vich ns frnrtt all
tianrtacwr7�rrbcunr[actor ur cantrell,Ytl�n cif peen, A permit cahoot 1)c cancel ed if work fnas been performed.
sic;vr�rt7tL�� -~_•- ,
R trtr ���-nCrd,uilder') - • -
Slf,`i,41t,'itEC.EVt< ca"i R.Nf
NnOk rut
F'e ii:7 AV..r'M
r'4(fti?'ta4arE j �rl'n���nr7 r
�srror`t�Io�ut�,Crxlrnpor3r Lutrcl4rntt, Tr L �- -- --
TI[e ;'atl,w irtu tcicryJtrC!!I ua,,rwk t��•dcJ,nl h:inra mr Uri:
OtF
SI M1W'kS.�
gn lore or Notary Oalr
Eofl
jrr�ubbc Slate of FlOnda
Hannah � Moore
My Commi3AonHH 0 f7094, `-�P res 07101rz02(1
1Lt[t Pf Ftatufa (`�+;rely vise. Lrrnc Crw1C/
tF: t�tln[rl:t� a [runurl ua: a; k: nwJ^dgcd brb
t! d:ry (,r �b l d+l iZr« re nc a,,
�4-. S 5, +lr.rrc!+testr*!Jy kikor:u tp
r r r wt a lta, p ducxd _ di tC3
4(grutlure of N.)Ijtry hate
=07:01120124
c Stale of FbnOaooren till Ot 70951r102d
PERMIT p 1 1 ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
Ehman Electrical Contractor, LLC
(Company Namellndividual Name)
the Electrical
(Type of Trade)
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to be
_ Sub -contractor for Adams Homes of Northwest Florida, INC
(Primary Contractor)
For the project located at._ 3 L- U p ---&.
(Project Street Address or Property ID #) �
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.
CONTRACTOR SJGYATf AE IQuatifieri
St R COYTRACTOR SIGNATURE (Qualifier)
W Bryan Adams _ Timothy L Ehman
PRNF IIAME PRIW iIWIE
29179 _ _ _ 31748__ _
CCOUNTYCERTIFI(ATlolt j C-( BER CO[ \TY CERTIFlUffo_ Y BBER — ' —
state of Florida, Count► of St Lucie Stare of Florida, County of ST LUCK: } The fortgo#qg instrument nas signed before me this f day of The fortgcing instrument was signed before me this I rlav of
W. Bryan Adams F'
_��n f ,20Z1y Timothy L Ehman
who is personally known )�, or has produced a _ who is personals) known X or has produced a
as id tifcation- as Idtalllica ion.
STAMP A-7; STAMPSi �t o- r lie SignatufeofN'otifyFame
�acra 7�1
t , 'amr of N ry Public N�i\\11S�/f��
\``N�b Priat l\eme of Rosary Publi��--
,� � AGM 2? FE'oto•.
,rt"m : ? :oo" Notary Public State Of Florida
Laura Townsend
Revised 11 Itin01G My Commission
SOo RiFJ106177 .y�n HHti5496
;A ,ao a �; Exp.91J312o25
iTP '•yA°4drd rho r\e;• �Or