HomeMy WebLinkAboutchange of electric contractor`< _• PLANNING & DE VELOPNZEN'T SER VICES
• - BUILDING & ZONfNG DIVISION
w 2300 VIRGINIA AVE
FORTPIERCE, FL 34982
(772) 462-1553 FAX 462-1578
CHAIIGL OF CC)NTUAC7'OR, SUBCONTRAC'Tf)U tt,n Irl A �1 _
- - - ..,.. �..,•.l. �.e�,,�,.a 1 101� OF PERI<1T
YL[A.S[_ %[.,LCCI CENL t)i" I`i�= ,c [ ntw rN(,:
CIfiANGE OF CONTRACTOR —
an:!the r,eta contractor ctfrce0irl fur the eurr'e tttdFtl ntit Ae of or,tCµ tur is to be sierlecl and norarired by
nc� Property
contractor infurmaluul rind ;ignaturc. A neu Nr�t cc of C.'itntmcncentent mt�tit be filed in the new contractor `owner.
permit at, 1mrttion ,trust also be completed ri', rtr e
for job tahtc, grealer (halt S2,500 i•S7.500 if A!C Chlutge_nut). A recorded cctPy must be submitted
commencittn name
h any work. T'herC is a $50,00 fee fnr the Ch;tnge of C'ontr•actor. Pnot to
x CHANGE Of' SUBCONTRAC R)R -• Subcontractor changes Ire to be cnttt uteri hs' the r
Tltr new subc«ntl�tctor nul;t tit? out a Subconirartor A��rcernant Form There is a $5(}.Op fee !'or the Chano
Contractor,
P ' erterrt� rotttracta.
,e of Sui:-
(:AIlrCEI.l,,%7ION t?! 1'lvF1N4)1 — (hc exneeifatr311 of a pertttrt is tccuptabfe only it nc, utlrk ltas bras done ,
{'aneelfati"ln of pfPl it 1> to be Srgr'rli and ut�tanaed h1' Loth the Owner and qualifier rtf record. There is no
caneellatinn of the permit•
fee for
Date.
Permit Number:
Site Address:
Original (rC•, subcomrarlor or i,�4ner L,tlrliicr _." "_ State f_iccnsc_gG!_
t' ipchLwj T-
Ne►v 0C, suhcont -aclor '� 5t.ttc L iccn,;e� 7 3 0
Reasrnt lur C,nt�cilatruri
'i he underslincri
rnurntmry ,Ind ft,]ld 113rntless St Lucie C'otrnty, itr oil7cers, a.�cnt4 Erred cmpLtye4, frr,m atf
costs, fer i err dant��ci 8risinn loon an) arr,i ,I{ el,tinrs r,f arnt,n for any rcas+xi, +Lich iLS Ol ftr as ;, result Lit Change trf
canit ttbcor,lt -rr,t or cun�'eltatiori
n l,- I,ti'lnil A pet•mit cnlirlat t}c c:InCCI ed If ri'prl, }1a5 t7CCrt pCr fOrrtled.
tilC ti'i1 fL'12L' or U<{ V
t ,, ��nert)wlrlcr')
51:\At L'kE GET CON'rR.1r'�1'Utt r lrn�u�f;C ,�a a�tyPiK 1b'.I
t'rtrtil ivAVtE����i�!V
Ssacc of l'Ionda, CorIr1v of S+
the ti,ItJUurr t+ISir'�tT rh, ,�a:,
�ti,.�•.Ird•nl I•rri-rc me Uu,
ud
w- �• � rn�l.t'r., is : .
_ , [•araona I} t,-,ot.1t ro ntc
Slg lurenrh'orAry NOZ1)rrr
t�y f'ipublrc State W Flor..aa
Hannah E Moore
MY CommIS pn HH 0 i 7095
'%o�ndF Eap,res07f0Irj024
$1,,r:• of flawla. r"ounry uf$r. (�k c C t„ty
r�+: forrnx-,rrr;,r� Lr nrcr•.t nta i.'kruu'
daY nr r� i�cd b_!•,r1 n: +hi,
-T_ - F_h rnr'
-��,---, 5ti � Tahu r+ lurnr•,t,ll}' k,n;tc,i to
r r r wtyl l,at p Idui. d
Stgnutureortiotury Dole
+o�� ��� Notary r'uC4c 51a* d Fla, as
Hannah E Moore
�"• gyp• µv Commission HH a,'09.
>antf' Exp�res07:01ROZ4
PERMIT 0 1 1 ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Ehman Electrical Contractor, LLC have agreed to be
(Company Namer'Individual Name)
the __ Electrical _ _ Sub -contractor for Adams Homes of Northwest Florida, INC
(Type of Trade) + + (Primary Contractor)
For the project located at
(project Street Address or Property Tax ID N) — T
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.
&iTRACTOR SIGNATt RE IQudifieri
W Bryan Adams
PRINT NAME ^
29179
COI'NTV CERTIFICATION Nt'�,tlatrR R '
State of Florida, Counts. of St Lucie
The foregoing instrument itas signed before me this day of
Ir'l�Jr 1c.r,ry , 20J.L b1 W. Bryan Adams
who is personally known Y., or has produced a
as idimlifcatiom
of N3tfi ry
Revised I I I6-2DI6
STAMP
k\\WSPRAST,4z— �i/6'i
*. 4P0
Q •• u AFYi 1061n
bhc Under. -pQ
STATE..t����\��
St'a.CONTRACTOR SIGNATURE (Qualifier)
Timothy L Ehman
PRI\T i\AME
31748
COi�\Tl' CERTIFICATION I�[\iBER '�--�--" �-
Slats of Florida, Caur ry or ST L.UCIE
The foregoing instrument was signed before me this. „ dap of
-�ZL'4A.•t ,20,E,J4. timothy L Ehman
who is persanalljt known X or has produced a _
as idrnliffea Ion.
STAMP
Signature orr\otary P bile
Prior Name of i\etary Public
ya Notary Public Stale of Florlda
`F Laura Townsend
MyHko17543SIon
EXp.9113/2025
i