HomeMy WebLinkAboutchange of electric- --J,_ PLANNING & .DEVELOPMENT SERVICE S
BUILDING & ZONING DIVISION
' 2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578
CHANGE OF CONTRACTOR. SUBCONTRACTUk ()R CANCELLAT1n1` r
_hILUg
S'lfi Ivy
CHANGE OF Cpti-I'I2ACTQR -- ('}1i;nee n f Conte:•tour is to be sigrte[t and nc�tarirecl by the Property owne
and the nc>t contractor of lecord for the current permit. A neu
contractor iltfo�nattnc. i1 ttew Notice, and sin permit application must also be Completed With rtem,
OF Comrnencentent rMW be filed In Elie new contractor', name
fnr Job %d1LICS gresler than S2,500 (S7.500 if A.-C Change-ottt}. A recorded ccrp5' must be submitted
conitttiencing any work There is a $5o,00 fee for the Change or C:orttt-actor.
x d prior to
. N CUANGE UI" SUBCONTRAC I'012 Subcontractru- chatlgei rzFf✓ to l)c colttjlleied by the !;eneral coarrac
The ncty sabr~ontt;tctor must till out a Sttbcorttrac;tor A4�reement I-'orrn• There is s 550.00 fee for the Change Contractor, tot.
,e of Sub-
t'ion. o f .f.I„ it IOt\ qF 1'1:11 �41� — 7 he cxrtceliario[t of a pct•ttut is accel,table onty 11 net ,�vrk has hccn don
c n cellatioll of permit r; f to s,g,t�•ti ;1nd lli)Yar17c(1 t14' tiDl}t tilt UL4nC[ and giralificr clt record. 'There is no
canccltatinn of the permit
fee For
Date:
perntit Ntttnher: �
Ji ._
Site Aticlreas: _ _
Uriginitl (i{..,subcontractor 01 rntinct 1-tlrlltfcr Slate License
lVcw (;(.•, Stthe0)f,I tt 1 SUlfe L-icen eV.��� 7 �
�yvSLCi-iccnse
Reason fut Cin1, cl13t10;I T �
The unc}crsi};gcd dnec l,ercb} agree to n[d:n,nify,lnd hold hirmless Sr Lacie C'ol[nty, its uflicers. ar;et~t1d cmi,loyers Frnm a
casts, Fees o, daltil tcx arr,rn�; irr,rll arty alld al; clans, rlfac-ri[tn for any reason, which all arix as ;t rcxrlt ut fins ch.lu
�t�nlracwrfstrbwnnau�rr r+r rincctlaiwn ufPeltnl[ A perrnit atnnot t>r cane rd if ►Tort; ltas been Performed.
11
3 gl trl'
. 16T'N%rt'RL r,I-[31hVf R {nr ,ur�Yhuillfrrj
.4ti v.�l U[t C IE:4E CY]\ rrt,�S "rI]i2 for ncu�( r. le apl,lii:,b cf
$.ulc orf'IarulS, [:r,rtoty of Sr [-uut i6,trt,,IIEW."T NAME-
w �—`
TII: ?.7[I.unrgltur.pc t,�.I.,Lrux •1cJ c�th:4If,nudu;
W��' ..., m7�],.'1'> it {•el�o:lbllS lrkrrAs wltar
r T
P� h �as
S I Ato ,
0 rllrC Qf ivAf8r1' hate
E.00
�e'�7r�' ubliC Stale W Flt,r,daHannah E Moore
MYCumm9stonHH�. ERpreelll.Ot 9b
rZ024
11Ar: cif Flxvrn. [.ow.h, of ti, Lfw �I: Crnl `r?'
rI'`: fJ[1Rh1:1�; Ln.t;IlnJ�'nl uac , i
—dbyni dgrl� bdwt: me9�
11 My rhHy f.:,,ix7r In
1 r wWblk bax pr d T...L
a, Ip.
YS(21 lure of ;safarp Date
;a+�" •f4r� Notary NMI: State d Flof.da
Hannah E Moore
¢'_ • My i :nn-iss+on HH 01709E
''poi P- E.p�res [17-01r2024
PERMIT ff ! I ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Ehman Electrical Contractor, LLC _ have agreed to be
(Company NameOlndividual Name) w_
the __ Electrical _ _ _ Sub -contractor for Adams Homes of Northwesl Florida, INC
(Type of Trade) (Primary Contractor)
For the project located at
(Project Street Address or Property Tax 1D 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.
a CONTRACTOR SJGiNATI RE {Q fiery
W Bryan Adams
PRINT NAME
29179
COUNTY CERTIFICATIOI K ti1BER - --
Stale of Florida, Counts of St Lucie
The foregoing Instrument t+as signed before me this { day of
,20p_ by W: Bryan Adams
who is personafly known Y. or has produced a
Revised 11. 16..2016
STAMP
sPRA S A44r ,��i
VIC
27
S x ; e #lfi 106177 * �
St R.CONTRAcTOR SIGNATURE LQualiferj
Timothy L Ehman
PRAT NAME
31748 __
CO INICATTV CERTIFlO_,'q Nl'SIBER ' —
sure of Florida, Chanty of ST LUCIE
The foregoing Instrument was Signed before me this day of
!a(k4-?- .,2oZ4.j�y.Timothy L Ehman
Who is personally known X or has produced ■
Issildleallillce ion.
STAMP
Siggat�ayr�r,ofNotarp P�bile
t� 1a 1_�
Prlgl Name of notary Publir
or►*•�e_ Notary Public State of Florida
e `� Laura Townsend
v•� f MyCommission
HN 176435
bjm�o� Exp.911312025