HomeMy WebLinkAboutCHANGE OF CONTRACTOR�- PLANNING & DEVELOPI7ENT SERVICES
• BUILDING & ZONING DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1 SS3 FAX 462-1578
CHANGE OF COVTR:XC1'OR, SUBC0:ITRACTUR OR CANCIrLLAT1Q11 Q
PLEASL St;LCC7 C)-;)f'
CHAtSiGE OF CONTRACTOR_ ('hange of Co(itracror Is to be. signetl and riotari,7 b rile
stud fire new contractor ofrccorrl for. file �u.rrenf perrrtrl A nek
for'
job
1LICS g eater nh ;ign ,500 A neu Noticc of (om[ttencerntinl rncLsF be filed in rite new contractolt �owier.
PC -mil alzplication !dust also be Cornpletc(l ,Vitll n��t
for Job (;flues arealer than $2,SOU (S7,5UU if A,C Change -DLit} recorded cap} muit be submitte
conuttGncin� . name
any work. T'hcre is 2 $50.00 fee for the C 11,11,ge of C'outractor. d Prior to
X C;IIAI\1CL U!` S[ BCUR'7 RACEOR -• Subcontractor changes are to be conlpleteci by the ffencral
The ne a subcontractor mnst till out a Subcallfractor Ag'tet ment Form. There is a $50.00 fcc far the a arro
Contractor. 7 cat!rrac(ar,
,e of Sub_
of 1,1„A't'IOl\ pf' !'I f2 117 - 'f Ile cxnee"ar[alt of:f 110rulit Is .tcceptable oltl)' it no Mork IUIN bcert clan
(ancellatinn of frertnit t> t. hC Ngried and fh)-irizcd by both rite Owner and qualifier of record. '('here is no
canccllatinn of�thc permit.
fee for
Date:
�- Permit Number. J 4 .
Site Address:
(�GtrC� rL
Uriginstl (.i(', srrbcOntracior Ststrc ! i-c:nsc ol'itunel htrrlflcr _ f --
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NC►Y (JC', .suitcclltt L �� ILA- SWe Lieen,se�u i 7�
Reasclrt i'ur ('8n�C1l3tIUl!
lnnent trty and hold lt3fnlleSS St Lucie County, i[s oflicers a.f;crtls and cm(t&ayees frnrtt all
costs, Pecs or drtut,i .rs drornt; lrallt ar a,rd all clar'm; aFarrFnrt li)r any reason, uFtich Es 0 F1Rg� as :t result ul lirl� cltan r lit'
— ciltlrec[�rrsu6cunsl l-rrtr or cautceltall�n or"fhrmN. A per'mff rfnrnur t>e cancel ed ifirori; has been performed.
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(71tn hire of i\'r)ran•
Date.
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-bl. State a Flor,tla E MooremrSsr- HH 177r01Q024 0 09b
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ID
Stgnarure of tirfnrp -C
=off •��F Notary Vubhc Slate of Floroa
Hannan, E Moore
• MY Carnml$slon HH 017099
�t>:n E■paes0710tr2024
PERMIT # ' 1 ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Ehman Electrical Contractor, LLC have agreed to be,
(Company NameAnd ividual Name)
the _ Electrical Sub -contractor for Adams Homes of Northwest Florida, INC
(Type trf Trade) Y (Primary Contractor)
For the project located at
(Project Street Address or Property Tax I 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.
CONTRACTOR S1GNA7('fi (E Qualified
W Bryan Adams
PRI.\T I A,ME �� --
29179
E-0VNTY CERTIFI C AAT101, kt A18ER�
Stute of Florida, Counts of St Lucie
The foregoing instrument tiassigned before me this _ day sf
r,05014ry .20 ") W. Bryan Adams
Who is personnily known Y, or has produced a
as idouificsiion
I Name of"
Revised I I.16.2016
St &CONTRACTOR SIGNATURE (Qualifier)
Timothy L Ehman
PRINT NAME
31748
Cdl�\T1'CERTIFiCA7fOV n't;�[BER �"—`--"
Starr of FtondA. County of ST LUCIE
The foregoing iitsrrumral was signed before me ibis, af1a� of
�% r ,20 44y. Timothy L Ehman
Who is perspnalry known x or sus produced a
C es;drnufica rua.
F STA 11P
Signal"' of \olery F He
> ublfc ��1111111Mif1Tj
`�\\��Sp,RA $l,��y��////� Prins i�'ame of Nolsry Puhtir
,r,r • tQpv% � Notary Public State of Flor!da
Laura Townsend
a *fH 106177 * _ -iE"oat+� myHHt 754351Dn
payy'. a dt Exp. 9113/2025
•fA?/b/�ded lk+s'' 4.' apt
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