HomeMy WebLinkAboutchange of contractorL - j ` .` PLANNING & DE VELOPtNIENT SER VIC: F:S
• BUILDING & ZONING DIVISION
• 2300 VIRGINI A AVE
FORT PIERCE, M 34982
(772) 462-1553 FAX 462-I578
R OR CANCELLATION OF
PLEASI tiE:l..CCT C)NL�I_f
—CHANGE OP CONTRACTOR — (hange of Contractor is to be Signed and norar+zed
and the new contractor of rccl]rfl tug the cut'renl permit. A neW permil apphe4ition must also be completed �rltlr [
b} the Property owner•,
contractor r tes L, tiun and signlrurc. A neti Notice of C'onr[ncncemcnt r[I[rsr be fifc�i in the ncu contractor's
i'or Job talues greaser than $2,51)0 [S7.SDU if A;t' Chrntgz-otrl}. .A recorded co ]�w
commenciu�1:1 nantc
any work. There is a ,550.00 fee far the Change of C'nutr. actor, py must be submitted prier to
x _C HANGE OF SUBCONTR?\C fOR -• Subcontractor change" are to be cpm f�teci by the �f
The new subcontt•actor [nuat filf otll a Subcont -actor A�,rcenlenl Porm. There is a $50.00 fee for the Chang
Contractor.
n ' ,eneral contractor,
�e of Sub_
o f p I. llil is ON 01' !'Fa2++\i1T - f he cancellarloty of a per1111t IS Ltccc.ptubl�> only ]t n(1 4l'UI'l� f1ilS bi'CII d(1rrc.
('artccflatil�n of permit [: to'. �' lml rowed b�• both otileOwner a►ad qualifier rIf record. 'There is no fee for
Date: —aQ.U�
Permit 1�iutrtbcr: �p�l• p%SGf
Originnl (;(.,, st,bcontraclal- or {n4ncl 1„ icr -- — State License
License
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nKLr l In Ir►nerll:vfy ;lnd 11Llld 1�arnlleSS St Lucie C'otenry, ILy ut[iccrs, as crrtti ant! cmphr-Frnit[ :►II
cads, fees or drutl rzr> arisrn� from Anti• aird al; cl-arpt•i Crracti(Ln Pot arty rea5'pn, �si�reh nr ly F Officers.
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coniract{r',ubcuntraer(LI ur canrcllatron oFVeTlnrt A permft cannot 1}e camel eV if w
� ors; hils been performed.
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Srgn rare of Norary
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EN
Hannah E Moore• MY Comm SSLOr1 `- r<p�res 07101 1W24
5r ltt Of 1=iamla (Oue [f qC$t. I_Ili rC C(f;L:ny
rarlowl.ii; ILL frLKINT..1 t41:
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Sigr[rLturc of Notary Dart
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Stare or FlondaooreL-8 Ot709Sfrlp2a
PERMIT # ! 1 ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
Ehman Electrical Contractor, LLC
(Company Namelindividual 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 5 3'J Lie' � y
(Project Street Address or Property lD 11)
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 SIG,YAT1 1tIE lQuatifierl -- -
St R.COYTRgGTOR SIGNATURE (QudifierJ
W Bryan Adams Timothy L Ehman
PRi\-r 11Ah1E PRIW INAME -
29179 3174$__
COC�TI CFRTIFICATfOA NC,�IBER COU�YTI' CERT1FiCAT10,Y ht'�it3ER ��� •�""
Stole or Florida, Count} of St Lucia ST I_UCIE
srur ornorids. Cavrtvor
The fortgcing instrument it As signed before rue this day of The foregoing instrument was signed before me Ibis day of
20bl_W Bryan Adams
,zot'� by Timothy LE
who is personally known Y. or has produced a who is Personals known 41k, or has produced a as id tification. as IdenflAce lon.
STAMP 11e STAMP
Signature of Notary P blie
P INemeorR r) Public 1\1111111fitilj�l/� A7ri-a I
NameoiNotary Public r
-,WA S T,.Q
:orF'•r+a Notary RubFlc State of Florida
Laura Townsend
Revised 11. *2416 : * 2 My Commission
S Z ' Z t911I1t7d}� S HH 115435
y0�:�� arts Exp.911312025
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