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PLANNING &.D,EVELOPjN7ENTSERVICES
BUILDING & ZONING DIVISION
2300 VIRGINIA AVE
F0111, PIERCE, FL 34982
(772) 462-1553 FAX 462-I578
1RACTOR OR CANCELLATION OF PERMT
CHANGE OF (`O'vTRACTOR — Change of C.001r.lClor is to l)e Signed and n��tar�i( cf b '
and the new contactor OI•recor(1 t()r file torrent permit A nek
contrxctol informatrOn and Signattitc. A net►' Notice of (v'ummencenlcnt incur be filed In lso new m property owner.
permit alll7hc:rtion must al,o he r(llnrlelcd w1tll r,rt�
the
i'or job lalue, ,realer than $2,500 (.S7.500 if A+ _ caluu�ncitl� � (' Change -out}. A recorded cop):itiactor-'. name
an ' wolk_ There is a $50.00 fee for the Change of Contractor, Ittusf be submitted
x CllANCE 01, SUBCOlt1 RAC'l'Olt -� Subcontractot change; are to be coin letz(l }, , prlai to
The new Subcontractor' must till out a Subcontfrlctor Agreemcni Fornl. There is s SSp.00 fee for lh
Contractor. !' ! r}re �encla! (onrractol.
e Change of Sub -
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C' Ln: efla[irlri f}f rPrnlit i$ fa be si�nx'.,I :ule! itminled ilk• bmh the o(vncl Is copra zr ot` r•er t►rd, 'There
cancellation of the permit. i dnr,c
is no fee for
Dare: _ ,I I�
Site Address:
Original (;(, ,ubcom111c.t0r of 411511t'I l7trrEilC1'y
Reason Iu1 (':rI1.`C113tlVr!
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CUSl.S, Cicti Pr (1iilrkrZCi 1}rr5nr..
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c k ah:a-.tt,r'>:Ibcutr(a crur ur C:ulLelratron (1{ I>tnnrt .1 prrmif cnnupf he cancel ed if +torn; tlos hrcn perfornie.d.
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Hannah t_ Moore
�, y~ My Co+rtrresron HH 0 r' 19:
+p, M1d� Expires 0110I 2024
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=07101(2(024
lic Starr of Flom Moorerssron HH 01709S101r2o24
PERMIT 0 1 1 ISSUE DATt:
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
Ehman Electrical Contractor, LLC
(Company Name. Individ ual Name)
the Electrical
('type of Trade)
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to be
_ Sub -contractor for Adams Homes of Northwesl Florida, INC
(Primary Contractor)
For the project located at 311 jy� _�1�
(Project Street Address or Property Tax ID (I)
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 purstiant to the
tiling of a Change of Sub -contractor notice.
CONTRACrORSIGNATI HE ualirirrl
W Bryan Adams
PRIhTKAiV1E
29179
COCiVT1"CERTIFI(ATIOKNt',%IBEI2
Stele of Florida, Counts. of St LUicie
The foregoing instrument nas signrd before me this I day of
-d*Kl, 201 W. Bryan Adams . _...
wbo is personnlly knownY. or has produced a
ST,k',1P
f ar .
ft�.'
Revised It. 164016 Z
j � dr B • � 1
d cad nAe�r�4:q�0;`��
SI R"CONTRACrORSIGNATURE (Qualifier)
Timothy L Ehman
PRI\T t%qAkIE
_ 31748 __
COt_NT1' CERTIFICATION Nt FIBER'
Srare of Florida County or ST LUCIE
The fortgoiog instrumenl was signed brfore me this f _ itas of
,zovzrb) Timothy L Ehman_W _
who is personalh known or has produced a
as idrnlirira Ion.
Signature of iiNotary P blir
Print Name or lotary Public
ogsi•o Notary Public Slate of Florida
+ Laura Townsend
My Commission
fir,+ ' HH 175435
°r^.1 e Exp. W1312025
STAMP I
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