HomeMy WebLinkAboutchange of contractorPLANNING & DEVELOMWENT SERVI C '
BUILDING & ZONING DIVISION F S
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1.553 FAX 462-1578
OR CANCELLAT10N 0
!'LL-AS1- ti1iLCCT C?NL- 01- i FULL: Vt Iwi:
CIi.Ai\iGE OF C-O�+•Tl2ACTOIt — Change of Contl;rctnr is to be signed anct not<lriicd b • rI1
and the nctir coniractin oi-record for the current permit A new ) e property owner.
cOlfor job
Information and signature. A new' l�loticc. of C'umrnencentitntl�mtusl tbcrlfileiITI yin tlo new be olpletetor'sthn lew
fnr job 53lltCS me
greater than $2,500 (S7,500 if VC Change -out) A recorded cn
Commencing any work. Them is a $50,00 fee for the Change of C"ontractor, p), must be submitted print to
X C [1ANGE 01 SUBCONTRACT01Z -' S►Ibcontractor changes are to be Com leled hp the tr
The new subcontractor muS1 till out a Subcontractor Agreement Form, There is a $50.00 fee for the Change of
Contractor.
P ,enEral cotrrractor.
Sub-
- ('ANCF1,1, 1'[ IO[\ ()1. 1'I: [Z.:Y117 — .t he call celfarr,)rr bof.
f er Ilerurit is �eccptabie only it no k+urk has hc•�rt donee
( ;�nceiiah,)n of permit is to be .IgmrLl and nor ann��f t hoth thz a►vncr and drlalifier of record. There is no fee for
Date: _ _
Permit Number: F
Site Address:
Original (;C, subcontractor or o�tinrl lutildcr Staic License t�C _(f ��
,3-- .._�Al-C License
Netiv(aC',stthcnnU�dc[cn' — � -- — _.�__SL(:1.iocnse ��Tb
Reasotl tiul'Ciur�cllatrorr
11te unticrsir Hitt ,�.n _ t..
„Z; i — rrtacmorry Mid ht)ld hir illesS SE Lucie Count ILr f111rC'er,, a
C'o51ti, fee; nr dru,tdf�t:C �rrsir.o ltp(n llf11 411Li dli c1Arm, of uetrr,n 1soi anv rca
� .ircnts flr:d cml,tayc�c�s frnrtt.-tt!
c�}nl,a�rUrf,ubcun[rachn ter calnrrltatlall Jr Ihrrnll A prrmri r[lnnor he cnnce ed if isarl; Ilas been performed.
So11, which n, y arZso I, a result of flits clrmgr of
SfCitiAFUEtt: �riv Tl+rhr uk'r,�Yburldir'1 --' 1
{ S".� NAI URE GE�rr: Coy 1 rt,%r TUk fat fk'l4 [ 1I t{
1�[tfti7 ra4+�FF i rv��h
Swtc of Flimiiu, C glnt� Of Sr 1.Kic LCrLmi Y
ilrc::;L,um rn:u me^+u.na�lu,tr..li.l nlh:fir:111COff,
lro�w,tua,,
4�or :� t, prudt, ti .�
Sign hire of Nora, Dytr
�':�VV
d� .,� 7ipuDIM Slate pt F11 40a
Hannah E Moore
My Cornmiss on HM 0170%
�a M1dF EKpues oIto 1'2024
tirar; �f r'fon,ia. t'.,ur-ty pf tit, t.u; rc Cau+ay
, i-dgCd h-!Sire 11� !ht,
T E
StS. :sIll �<lkfgr r l,Ily l uJv,� Ei
du;Zad
StAnHlurcur orar�' Dare •_.._
+p+►/� �W� Mowry PuDltc Slate Or Flpnda
Hannah E Moore
S - p• MY Commimon HN � 1709(,
ylpt. nd' Expires 071011`2024
PERMIT # I ! ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
Ehman Electrical Contractor, LLC
(Company Name-Andividual Name)
the Electrical
(Typc of Tradc)
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to be
Subcontractor for Adams Homes of Northwest Florida, INC
(Primary Contractor)
For the project located at
(Project Street Address or Property Tax ID 1))
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.
CONTRACTOR SIG,YATI RE (Quat(fierl.
W Bryan Adams
FRI,rT IYMNIE--
29179
COUNTY CEPIFICATION 1\t',1t8ER
Sialt of Florida, Counts of St Lucie
The foregoing instrument uassigned before me this 1 day of
Febf �f,,. W, Bryan Adams
who is personally knolrn Y. or has produced a
as id rip lifica lion
r)
Revised I I.16.2016
STA M P
4RA S r,��Fy
,Q0 112.1 •
dyY11D6177 Ar
`y
aptk
;
�i� �' • 6j c Under: • Cj
IfSTA
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St A-COVTRACTOR SIGNATURE (Qualifier)
Timothy L Ehman
PRINT,NIAMIt -
31748 _
COUNTY CERTIFICATIO;! i�(\IBER
stetr or FloridA. countv.or ST LUCIE
The foregoing instrumenl was signed before me Ibis etas of
_-.. ,2ni1.e)_Timothy L Ehman
who is perscnalh known X or has produced a
AS gatureoriNiolfirzPblic
STANIP
Sig
Print Name of Nosey Public
ota*r&'� Notary Public stale of Florida
a Laura Townsend
My Commission
HH 175435
Exp. W1312025
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