HomeMy WebLinkAboutchange of contractorPLANNING & DEVELOPI7EINT SERVICES
BUILDING & ZONING DIVISION
• 2300 VIRGINIA AVE
FORT PIERCE, FL 34982
F COLN
(772) 462-1 S53 FAX 462-1578
R OR CANCELLATION
YL) ASE SI:LG{t s1NL�() 17i
CHANGE OF CONTRACTOR - Change of Contractor is to bi:. signed and notarized b
and the new contractor Of record tut the CUITCnt Y
I ermit. A ncu ) tlzc properly owner.
contractor ill
atiotY and ;ignaft+t'e- A +reu ►Notice. of C Commencement mtvit be riled in the new contractor's name
perm+! afaPlicali(arr Inu;t also be co(nplete(I «Ittr nct�
for Job values greater than $2,5{1{1 157_50U if .�rC'
cnmttiencinc any work. There is a $50.00 fee for the Clrar gr Or lrContractor. recorded copy tnr„I be submitted print to
x CIIANGL OF SUBCONILRAC UOR - Subcontractor chattges itre to be cnnTJnlctzil hv the k,ett a
The rac subcontractor must rill out a Sub outractor A��rcemeni Form Therr is a 550.00 fee for the Chance of
Contractor. urr� contr,trtot
5 Sab-
CANCmmil (EL rt,lit ION O]' 1'1 [ta�117`� i`hc' cxncc IFant�n of a perttut is acratatablt only nl no �«rk hus hrct� dons.
('arice) laton of taertinit i< 10 be kJ!lIL't3 and nt)tari7.ek1 by bol[r the uwTncr and c optaitr otrecord. 'There is be fee
Cancellation orthe Permit.
for
Hate: _ _ 2 2 Z�
Permit lumber. —�1 p(o -UI
Site Address: — -- —
OrrInr[ (i('L��111ti nl'I 11nt11dCi' State LicenseS,contr$LlQr Or' �C
Reason lur C'an,cilation
Tits undcrsiLned dace r+.•...► .. --
old
e�rsts fee, ok' drutittac t ,. Lifn > ONI any andrafi cla.0-,lr,f acrinntfrir any rc•3son �tihi }r n :t).L11ity, its f f risc'agagem
restrltnd e +�tcha'nsrf ram atl
L'C+ntt �sc(Jrr�UbCirrf [t8-tar ur cancelfallon c,flkrrna A per'(rrit Ckl rr rr4r be nCC
Cat e[t Y'0rk has fyCCn Performed,
_ ca It YK I
,SSIIGNATOIL 01- T-,,q R tar 1,w'crrbuil+lari -' _
SIC r:Ai t!ftE CiLV( Cn\ rk.lt T4)ft rsr uc,t Gr Ac a i'
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Of Sr I"lrc;rc l_"o,;l:kt
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Sign titre or �'rftarr Darr ,w
no_FnExpires
State of f on0a EMoorernisisonHH0170997r01r2024
SIX: of I-It7slds.(' )urlt,, of ST lar..p(rKr�ty
fl'e 1;7110A9tZg,il,tignli
2 eA} (,r t k-t,ttk died brh. rc ne th ,
' M�.r4+r21X��JrttL' RIWtc}I u,�
t t r whr hat r iWeed it IT),
Stgn�rWrco(Not ry T � 11e
r0 ►�� Notary Pubric State of Flor.oa
Hannan E Moore
K'- p• MY Commission HH 017095
•? Ftr Espires07MV2024
PERMIT it I ! ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
Ehman Electrical Contractor, LLC
(Company Namt ••"Individual Name)
the Electrical
(Type of Trade)
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to be
_ Sub -contractor for Adams Homes of Northwest Florida, INC
(PrimaryContractor)
For the project located at -5- y3,
Irro,)ect Street Address or Property
IF)
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
tiling of a Change of Sub -contractor notice.
CONTRACTOR SIGNATURE IQualiiteri
W Bryan Adams
PRl,YT KANIE —� - - -"--'
29179
COt i T YTY CERTIFICATION Rt71_8ER
Siale of Florida, Count► of St Lucie
The foregoing instrument ti as signed before me this day of
zo2+=} W. Bryan Adams
who is personally known a e r has produced a
as idolirsenlion. A -
STAMP
0
I'M i Name of hbf9r) Public \�>>�11111fit}1►7�f��/
1 �GtipH 2?io'
_* trLA
Revised 11 IU 2016 s o " lilg n '
101 f l 111111�
St RXONTRACCOR SIGNATURE {Qualifier}
Timothy L Ehman
PRIN'T,iNA11E
31748 _
COUNTY CERTIFICATIO_Y nt•\IBER
Stare of Florida, County or ST LUCIE
The foregoing instrument was signed before me this dal of
Y_A�4 _,2oZAy-Timothy L Ehman.
who is personally knolt'll J or has produced a
as Idroarra ion.
Sigaalure of \olar�__
STAMP
Print Name or Notary Public
oa+71�o Nolary Public Stale of Florida
: Laura Townsend
s My Commission
' HH 175435
otn Exp.90312025