HomeMy WebLinkAboutchange of contractorCOUNTY J
F L D R E D lit —r
PLANNING & .DEVELOPsMENT SERVICES
BUILDING & ZONING DIVISION
2300 VIRGINIA AVE
FOR"I' PIERCE, If'L 34982
(772) 462-1553 FAX 462-1578
— — — "..-,., ..� � y►r�l..lJ.L1,ATIOI� OF PERh1T
� CHANGE OF CONTRACTOR — Change of Contractor is to be signci! alto! notarized b 'the
and the new Contrarlor u!'rccorrl for the
ty Owner.
Contractor itlformation and sipaturc. A ncuerNpt cell �otf A ne"cncentcnll,.ilic njug tbcn ITIdsln also
be c contractlr�rltIl 11cu for job t aloes greater than $2,5(JO (57.500 if Ar(' Change -out). A recorded arnewconuttencirtg anY work.The is a $SOAO fee for tlrr C'ttange of Contrartnr. °r nantc
pi` must be submitted prior to
�C lIr1NGE ()! SUBCONTRACTOR subcontractor. nttt;tll o[tt Subcontractor- changes iIfrr to he conTftleted by the rren
The newwfia SubCOntrlctor A�rreenletit Form. There is a $50.00 fee For the Chang
Contractor. � c.kJl1 t.untractof.
�e of Sub-
----1 ANCEI.I.A770,\ Ol ! ltc cxnceffarrotr of peruut is accoPtable only it tier > wrk lxts llcrt, dnnc.
C'ance!latitr€ of Prrrttil ,s to be and noriri7ed by both the owner and qualifier of recnrd. 'There is no Fe
cancellation of the permit.
e for
Date:
Permit Number:
Site Address:
Or {,+' sub -�� rl✓ State 1-icemse
w.tl s
(.i(r, trbcontta��tor or uunet 1ltnllki
1Yetr C;C', suhcontr.trl{tt crnae_ ._ L(- I..icusc 39T9
Reason fur Catt�rllahotl .___ __,. _ _
old
co,sr., fees or drrltl:t�cs al-isln�, from tiny ,ltl, <lrittaslrrf ut�[ crnthe$ �S Lca.nu uh it n 5'ullcy, its Iari;; gas , d4CIIIS
f ti�.lc9t n> Fmrn atf
rti},ur4ci �rr;trbwrTl= {rr ur c:utretltittJlt of lxrmil A permit ctinnot be cane ed if work has been performed.
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PERMIT P ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Ehman Electrical Contractor, LLC have agreed to be
(Company Nameindividual Name)
the _ (Ty
Electrical _ _ Sub -contractor for Adams Homes of Northwest Florida, INC
pe o TTradc) (Primary Contractor)
For the project located at ( x -r -I k l � -
(Project Street Address or Property Tax ID 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.
e&TRACTOR SIGNATI RE (Qualifier)
W Bryan Adams
PRINT DAME
29179
COI'NTI'CERTIFICATIOWNt.%LBER --'+'-
State of Florida, Count)-of_St Lucie
The forcgoigg insrramtnl n as signed before ine this I dap of
,204bt .W.. Bryan Adams
who is personnlly known Y, or has produced a
as id iifcs6on.
Si ■1 a N r - lit STAMP
1 Name of it r) Public � %%%Ifl#tlii/
\, c NRA S /110'�i��
s
Revised 11 16:2016 ; o *W 100177Ed
* 2
St B.COYTRACfOR SIGNATURE (Qualifier)
Timothy L Ehman
PRIWNA41E
31748
COLViT1' CEILTIFICATIO,Y f♦'(\f13ER
Sure or Florida, County or ST LUCIE
The foregatag imtrumeal was signed before me this �_ dat of
,bvt.r4
__,24ib,. Tifnothy L Ehman-�
who is personalb known Y_ er has produced a
as Ideallfltalion.
'- STAMP
Signature OF Notary PlIblic
Prior Kam& of I\otary Pu61ie
awe" Notary Public State of Florida
: Laura Townsend
My commission
HM 175435
ar^ Exp. 911312025