HomeMy WebLinkAboutchange of contractor. '. PLANNING & DEVELQPINIENT SERVICES
• BUILDING & ZONING DIVISION
' 2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578
-- --. ";' ••� �•R����Li.AT10)\ OF PERhZT
w�l s[ SrLcrr c� OF T(i a-d ".Iwi:
CHANGE OF CON-URACTOR -
('hange of Contractor is to be. sipecl iztt(I notarized b the property and the nc►+� conhac'tor of rccor'd fo1 fhc cu.i'r'ent t
contractor information and signat(nc. A am Notice of C'ommencemenr mtLrt be filed in dte new cot tractor `owner.
t crntil A new Permit application must also bt cnrttgleteCl �tiih new
for job ~aloes grealer than $2,500 (S7.500 if .A.C' Changz-attt} q recorded cct r
comlttcncing any work, There is a $50.00 fee' for the Change of C`ontt'acttir nantc
p} Inust be submitted print to
X t:11ANGE OF SUBCON1 RAC-f-011 -. Subcontractor changes +tee to be cornPEeted ht the tfen�
The ne1V Subcontidctor lml;t fill otit a Subcontractor Agreement Form. There is a SS0.00 fee for the Change
Contractor. 7 aril contractor.
of Sub-
_1160n f pelll7IU\ Uh 1'I Et.�117 - 't'lte cxncelfarOil of.t pclltttt is acceptable only It Iltt 14'Ul'it h;iti hLCrl (I{,nc.
C;anzcllaritin of pellntl 1. t0 be ,rgnod and 110tarized by boih the os�ncr :end qualifier of record. 'I'
cancellation of the pel-mit.
ltere is no fee for
Date: .— "-'2 �� 2Z
— — -- •� Piwt•mit hunibcr:.-��= Site Address:
Original Ci(,, subeorltliaclor or intinol 1,tiiltfcr - State Licen,c eL Qprj' jc
Ne►v C.iC.', 5uhc(,nu'actttt _ . State 1. icen,.; _ _`.SLC Licelt;c 30 41?
Reason foi-Canccllatioll `
r �� rY rrm,ltrnrry and hold hsrntless St Lucie Cotinty, its olliccrs. t•t;entx noel cmpLt „fn all
cods, fens or d:trtY� cs arising linen WI), and all rrjFn,y crf a,tinn for any rc c{lu which itifiy aiier a, a re". i (' [h1a eh;tngt• ul"
cimlt r.tnr�sir6cunuactor or c:uiccllatwn of IVrinit A permit cannot be cancer e(1 ff tsork has been performed.
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er;�7ri�u0i+ei t'le a F o-,tla
Hannah E Moore
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Slgru'lurcufNotary —�� Dare
ad0o % Noary Pubic Stag 0f Flonda
Hannah E Moore
'3�' - MY Cr'nmssson HH 0 Y 7095
1an� Etp,resNiOtr2o24
PERMIT # I I ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Ehman Electrical Contractor, LLC have agreed to be
(Company NameOlnd ivid ual Name)
the _ Electrical Sub -contractor for Adams Homes of Northwest Florida, INC
(Type of Trade) (Primary Contractor)
For the project located at I - 1
(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 wil I be advised pursuant to the
Filing of a Change of Sub -contractor notice.
CO,YTRACTOR S1G,NATr RE tQualiGerl
W Bryan Adams
PR14NT NAME
29179
COUNTY CERTIFICATION Nt',1113ER
State of Florida, Counts of St Lucie
The roregoing instrument was signed before me this day of
I''�1Jtla. rr , toiL b,. W� Bryan Adams__
who is personally known ., or has produced a
as id lirualion.
Si as . o H r
lie 5TA\IP
t M1'a�me Of N r!
Public if."�/
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VIP
Revised II 16-2016
iMiFit116177
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Oad W "I.`~ �;
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�/r11111ttt11H�\
St' a.CO YTRACTOR SIGNATt1RE (QualinerJ
Timothy L Ehman
PRINT NAME
31748 _
COUNTY CERTIFICATIO_N Nl'\ItiER�—"--"
Starr of Florida. Courty or ST LUCIE
The foregoing instrument was signed before me this dui of
by TimothyL Ehman
who is personaly known ./= or has produced a
as identification.
STAMP
Signature of Norary P 61ir ''���
�ac?a-1
Print Name of Notary Public
E421
Notary Public State of Florida
Laura Townsend
My Commission
HH 175a35
Exp.911312025