HomeMy WebLinkAboutchange of contractorf L 0 R I D A
PLANNING & .DEVE,LOPMENT SERVICES
BUILDING & ZONfNG DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578
NLEASI�S[a.CCTI'} I UL1_ "Wl!VCi:
---CHANGE OF (:ONTRACTOR - (`ltangc of Cantt"actor is m be signed and notarized
and the rna► contractor o1'rcc.orrl for the c to rent }ncrmir. A neW bJ the Propert contractor Information and signature. ,1 ncN' Npticr. of Cumtttcncemt nt must be filet[ in the new contractor owner. arnc
Permit application must also he completed with rrcw
for job values greater than $2,5(}D iS7.50U if AC.' Cild"ge-out). A recorded co
Commencing and. work. T'herC is a $50.00 fee for the ('Mange nl Contractor, p�. in be subntitted
x prior to
�C11,1NGE ()I SCiBCOh I-RACTOR -- Subcontractor- changes are to be coin !c ted by the r,
Tltz ncty subcontractor nulyt }ill out a Subcottrrartor AL,reeuunt Porn). There is a S50.40 fee for the Chino
Contractor.
p �,erter,tl contractor.
be of Sub -
Contractor. JO,\� ()I7 I'T,12,1�1�� _ 'i"I:e canceitarrort of <t I,zrtrut rs accaptabfc only it no k��urk has bccrt done.
CanoelEation of peunet I: to he .Ignrtl turd lioran7cd by bosh the o%vnc, and qualifier of record There is no fee for
Date: _ _ d
Permit Number;
Site Address:Is,
Original 1/�
(;C' subcontrar'tot- Or Ctt4,)ei -11lriltler -- — 1✓ � 6slfi Lic{:nSc _
New (;;C'. sttntonu:rctttr 1' Suitt I, ictn,er-c394
Reason fu, C':rn,eNatiort 7
I he urtdersigrted dne� hereby auree to inderttnify ;tnd htaici h� a
cost, rec, [,I' artn4�es uri5rn, trt)rrr anti• and AI cl:tltni of actian (%)r any rcast_rnt uhrch May 8ri;i as .I re,ult of till+ ch,rn ; rrf
~lass St Lut:lg C'aunty, its officers, agents and cmpfr)}•res From atf
L'i�Fltf SG WrrillbCUnrE:[l',{ll' Ur Cdllll'i'[Iaiwn t�; tk.rtn,t A permit cannot hr. c•rnce ed if wort: has been performed.
SICVfI rL'RL r,l" U4t Nf R (nr ,�H ter build�.r'J —,
$I �NAI LIRE GEv ' -
�ttt to C•OVrk.Ss'Tpkrutn.«(.�'.o�+D,N4'tbt
—. _ r•iirtil rv��iE_",.�m6t�
The !c,[I.,,au:; tu:n�rr rr t n:n.raK;)dkdt_•n[ t,ci„r,• nu {,u:
pnca_sl) kno,nl te, rtt
AA�� xs tit.
Sr M_fW-�
�n hlrearNofur�• Dare
:EMoore
�nr
State or F ondaon HH 0 t 7D9b2U26
Star. cif 1't, ;d,1, Ctlur"tyof tit. t.uc rc coioiy
{ f.�rfCn, r;rt a ,trurtdrm ,+a: a: r;rd,uitdgcd btlure me ma,
fit Z�kfdt. 2t t,y
T,Erna,r,
t r wt:tt ttax p duced - �•'�
lk�m�
o,try PCIc
=10ji, Na:ary Public Stare or Ftor,Aa
y. Hannah E Moore
p• My , :.'n ssron HH pi 709S
?a �tfi E{prres 07,01/2024
PERMIT # I I ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
Ehman Electrical Contractor, LLC
(Company Namelindividual Name)
the Electrical
{Type orTrade)
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to be
_ _-y Sub -contractor for Adams Homes of Northwest Florida, INC
(Primary Contractor)
For the project located at b la _ 17
(Project Street Address or Property Tax ID #)
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 wil I be advised pursuant to the
filing of a Change of Sub -contractor notice.
CONTRACTOR SIGNAT( RE iQuaiifierl
W Bryan Adams
PRINT IYANIE
2917_9
COUNTY CERTIFICATI011 NCIBIBER `
State of Florida, Counts. of 8-t Lucie
The foregoing instrument»as stard before me this 1.,dmyof
6�4t , 20?Z; bl W. Bryan Adams
who is personally known T or has produced a
RA s ArFy10
27'�t4'
Revised 11. 16.2015
STA?IP
-7 r
St B•COYTRACTOR SIGNATURE (Quatirter)
Timothy L Ehman
PRINT i\A N E
31748
COUNTI' CERTIFICAT(O,Y N'[ hiBER —� '__
State of Florida. CPUr.tyar ST LUCIE
The foregoing imtrumeat was signed before me $his dat of
_ . , 20 A by Timoth�l L Ehman
who is personals known IK— or has produced a
as Idealilfral)on.
w���t STAMP
Slgnarnre of tVatery P bite
Print name of Netary public
allotary Public State of FloridaLaura Townsend MyHH 175475ionExp.911312025
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