HomeMy WebLinkAboutchange of contractorj ,_-- PLANNING & DEVELOPMENT SERVICES
- BUILDING &ZONING DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578
GE OF CONTRACTOR. SUBC0,1Z I�CTUk OR C
CHANGE OF CONTRACTOR - Change of Contractor is to be signet[ and notarized b rileProperty
:Ind the nett Lor,trac't()r of record for file currenf permit. A nett
contractur' information and stgnrlture. A neti' Notice of C,'umrltcn�'.errrtltl Plicmusbe filed in tilt rtew plowner.
pe+ntir rtl,ptrcation must alsp be cprt,pietcil with u4tt. fbr job raiucs grealer than 52,500 (S7.500 if A!(' Chang"tj(). Arc corded COPY contractor's name
r ally work. There is a $S0.00 fee for ttte Change of Contractor. p) must be subrttitted poor to
X CHANGE Ol SUBCON7 RAC 011 -. Subconiraclor changes are 10 L,c coot leted by If
The new subcont,ictor must tilt out a Subconu'actor A�,roement I orm" There is a S5o.00 fee for the Change Con trartrrr,
P the ,encral rctlttrrtetor.
e of Suit-
CANCE el-11"1 1O1 O1 1'IiR,?V111 _ I"hc cxnce[latrr�rl of:t poumit Is acceptable only it nu stork has heart ([one
c n cancellation
l anon of ttertnit t: to be .11€tort.{ and nl�?an7ed by both the otvnCr :kltd Ruatifii r r,l record. '17terc is be fee
rancrllatinn of"the stet roil.
for
Date:
Permit Number:
Site Address:
Orig1fl rl (.;(', subcontraclor or itttncr 1tl ilrlcr ~"" _" Stale ["le�:n c rL 7�
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C'OSty ter. or drut><,gc: ansirp� Irprn ttny� ant! aft crait„y r,f u Cron I )t any reason, tth,rrh n.:t} anyt as .r tllq [ ut Ihia rir.InKr of
c��r,ttact rrsuhcuttn tcsttr ur C: lticeifaflon Offle.rinrt A perm. cttrtnot !ra cancel eel if work has been performed.
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5(gn>rlureor.'otarp �Date
=Publoclre Stalu or FlondaMoore.. Hli 0, 709401202a
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 Name.'individual Name)
the Electrical Sub -contractor for Adams Homes of Northwest Florida, INC
(Type of Trade) (Primary Contractor)
For the project located at f-gLf Lt,S
(Project Street Address or Prop 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 wi;l be advised pursuant to the
filing of a Change of Sub -contractor notice.
�CTORt'RE (Qualifier[ S[ R.CONTRACrOR SIGNATURE (Qualifier)
W Bryan Adams Timothy L Ehman
PRINT NAME PRINT,NAME
29179 31748
COUNT1'CERTIFI(AT10ANt',�tBEii---{' "-- COi�,VTI'CERTIFICATIO�iN(�1$ER—
Slate of Florida, Count% -of St LUGIe 5T LUCiE
State of Ftar;df{, c000n' or
The foregoing inslrufslrnt vas signed before me lhls _ day ■f The foregoing instrument was signed before me this 2 fiat of
Bryan AdamsT -4av-fy- ,20zej, Timothy_ L Ehman_ _
vho is personally known Y, or has produced a vho is prrsonaly known X or has produced a .
es id (trick Jan. as idroliries ion.
STAMP STAMP
5' a o- 1' lit Signature of ��otary P6blir '"
P l Name orri r) Public 1111111H1wi
S Tij�F1" Prinl Name of i�aary Public
,C+QpGH2l?po,•' r�i
in : :oov'%, Nolary Public Stale of Florida
Laura Townsend
Revised 11 16:2DIti MY Commiaalon
4t11i106177 * +� o� HH t75435
S OVA � orn Exp, 9/13/2025
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