HomeMy WebLinkAboutchange of contractor'W"MI 7
COUNTY = 1`
r L Q R E t3 A _> '
PLANNING & DEVELOPINIEN'T SERVICE S
BUILDING & ZONING DIVISION
2300 VIRGINIA AVE
FORTPIERCE, FL 34982
(772) 462-1553 FAX 462-1578
NL1 Ast set t c7 r,r c) = rtLrot_t
—CHANGE ntiac OF CONTRACTOR — ('hangt: of Colltractor rs to be signed aild notarized by the ro e
and the new r onhartnr ufrecurd For the current permit A neu. permit atlpfic�tlon Ittust also be rnttl�letcd with well,
p p rt� owner•.
contest for mfarmatirin and signaturc. A nc%%, Notice of C'omrnencenient must be filed in the new contractor's Hanle
for Job values grealer than $2,500 (S7,500 if ABC.' Change -out A retarded copy must be submitted ricer
conutlencing any wort.. There is a $50,00 fee for the Change of Contractor.
X tel
—CHANGE 01" SUBCON7 RACfOR .. Subcontractor changes are to be contflle:te=il by the general contractor.
The new subcontractor must till out a Subcontractor Allrcenlent Form There is a $50.00 fee for the Change of S
Contractor.
s ub-
_ ._ _ation C pet -nit
'1701\T OF I Ile callecilariOn of it pernllt is acceptable ont}' if 110 llork h,a ht`ell done.
C'arlcellatinn of permit is to be signell and noranzed by both the owner and Qualifier Of recrlyd. There is no fee for
cancellation of the permit.
Date:
— — — Permit Number-
Site Addres.s: — — -- - - —
0righi (1 GC, wbcontr-ac.101- or Miner-11tlildel Blatt License YL�3Qvy' �
;ter A
t7or" �• St.ttc I. iccnsa 5 ,
11ie�v [;C.', suilcorlu"rlclor — _ LC License 3t7kf
Reason !(1l
old
harnifcS
costs, fees or dtrlttl P ,vs arising fiorrl tlity a� d 11111 larm tc racci(m ror any rr3ti0r� uElich it }f ficeesas a ll's ttndt fmplc i,t es Fr t
cllnnt all
cunlracwr�subc�ntlacror c!r cctlatlOn nf}><'rinit Apermit crtlrnot be cancel rd if wore ltri been performed.
Sr[;ti�CiLgt1 hi UNr,viR ('nr„k+SerUuilric'rf'
PRINT fi; ((`}} [ CC1V rRA TOR(-jrritn ap
f;C as phc:,b ct
,h'.�y - "IviteCIL414
PRINT 1-
$totcoi Froiah- l`ntlnl, at SI t.u�ie Lt,laa [
rtlC (i11t{11411t�' IIIj11,,j�li/',1t 5t;4+,l4rCtl..:.Ic=he;l h;luranle er,,,
itiijill >r J! H ltr �7 I1y
]tl!uIl[Spt�lrby lrtJs+ntnlllti
-as 10
I fort nr Noran Da
to
"- Y�ubhc Slate of F1,.,daHannah E Moore
MyComm ssion HH {'ornr10za
Expire%07)01
Slat: 01, Florida. ('Hugh of Sr. L!. ,e C'p;lnty
Fie fnllnt,•l;l� i,l:Inlnrcni uqa ackr�,,,.ird�cd brli,re me this
�.isptrsnrspllyLnoxn t�•
t` ""d
a, rt)-
51Analure. a(Nulary Dare
=,07.>01,S2t02,e,
N,c Starr of FnGa Mooressre111 HH 01'09v'01-2024
PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Ehman Electrical Contractor, LLC have agreed to be
(Company Name7ndividual Name)
the — Electrical _ Sub -contractor for Adams Homes of Northwest Florlda, INC
(Type of Trade) (Primary Contractor)
For the project located at_ -
(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.
4 CO,VTRACTOR SJQNATI RE (Qual'tfierl
W Bryan Adams
PRINT NAME - — -- ---
29179
COI\TY CERT[FICATtI)l. A't,\IB£R �"
State of Florida, County of St Lucie
The foregoing instrument Ives signed before me this doy of
rit6n4,e_ry ".zoo) W. Bryan Adams"
Who is personally known �L or has produced a
STAMP
Revised 11. 162016
St, 13.COVTRACiOR SIGtVATURE (QualirierJ
Timothy L Ehman
PRIW INANE
31748
COIF\Tl'CERTIFICATIO�I�i,\tBER�'� —'"-""
Slate of Florida. County or ST LUCIE
The foregoing instrument was signed before me this, da r of
, w Zi,> Timothy L Ehman
who is Personak known X or has produced a
as idendfles ion.
STA W
5111taltlre of Nalary P blic
Prinl flame of 1\olary Public
ta1VT" Notary Public State of Florida
Laura Townsend
[x r ' my N 1754351on
Exp.9/1312025