HomeMy WebLinkAboutChange of contractorPLANNING & DEVELOWKENT SERVICES
COUNTY BUILDING & ZONING DIVISION
• A 2300 VIRGINIA AVE
�I Ir FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578
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PLEAS I SLLLC7 C) L- U1= Tf�C f=UL1.+1�� tNtlt
,CHANGE OF CONTRACTOR - Change of Contractor is to be signed and notarized by the .
and the new contractor Of record for the current permit. A I'm permit application must also be complctril rth new.
y property owrrzr, contractor information and signature. A nccv Notice. of C'l�nunencement miatit be filed in die new contractor's name
for Job values greater than $2,SUt) f.S7.5UU if A�C Change -out)- A recorded copy [trust be submitted
commencing any work. There is a $50,00 fee for the Change of Contractor.
X prior to
ClfiANGE Ulu S[iBC01\''I'iZACTOR —Subcontractor changes are to be caT)plcttd by the Genera! cotttrdetar.
The new subcontractor must till out a Subcontractor' Agreement Form. There is a S50.00 fee for the Change aF S -
Contractar.
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—CANCELLATION ION (}F 1'l;[2,\117 - "f he cancetiariorl of it permit is acceptable only it no �> ork has hrcn clone.
Cancellation aFperruit is to be slgnc�3 and notanzed by both the owner and qualifier Of record. ere Th
cancellation of the permit. is no fee for
Date: 2—j l S12 Z
Permit Number: Zlb7-D7'
Site A(fdress:
Statc. License &L
Uril;innl (.i{ ,subcontractor of uwn,:l 1Ytnlifer 1�?4
.. I.0 License
New CiC, suhtorttraclor � .�Statc License.t� �$
�' ti SLC I.iccn.e
Reason lur Cancellation � �-�G,�— r�15 Le_-f
costs, fees rnaentnily and hold harnticst St Lucie County, its olfia cr,, 39e14s and employees from al!
cc,ntracwr�suSt dan>�r;cs arising from In).and all cl"i,ns of action for any reason, %vhich may' arise as a result ot,[ilibcultrtactur ur cairccli,tiron of perrmt A permit cannota c r,1rgr u1
be can ed if work has been performed.
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Sign hrrr prNohrn' r3atr
�t f7�upIM Stale of Florda
Hannah E Moore
hj'- y MY CommiSsron HH q 17049
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rvotary Put]t,c Stale of Florida
HannahEMoore
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Erpres 07r0ig020
PERMIT # ISSUE DATET I
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
Ehman Electrical Contractor, LLC
(Company Namellndividual Name)
the Beeldeal
(Type orTrade)
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENir
have agreed to be
_ Sub -contractor for Adams Homes of Northwest Florida, INC
(Primary Contractor)
For the project located at _ d
(Project Street Address or Property Tax ID Et)
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
fling of a Change of Sub -contractor notice.
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CONTR, C OR SIGNATI RE IQualifierl St R.CONTRACTOR SIGNATURE (Qualifier)
W Bryan Adams Timothy L Ehman
PRINT NAME -- — —" PRINT NA11E
29179 _ 31748
COCNTI CERTIWATIOA COUNTI'Ci?RTIFICATION!\[ 1IBER ��
State of Florida, County or St Lucie Starr of Florida, County of ST LUCIE
The foregoing Instrument reassigned before me this day of The foregoing iustrumeat was signed before me Ibis clay of
�t�rltG , 2obt W. Bryan Adams
- -... l , 20Li4 b) Timothy L Ehman
who is personally known Y—ar has produced a who is personaly known X or has produced ■ "
as id tificition as idealidea ion.
Si a V r lie
STAMP STA '*iP
ai Signature of. otary P `blic
1 Name of N ry Public 01%IItItFf►fr)r/
��\ ��5>; 0,Prigl Name or Notary Public
• ; - C H 2? Fte y
r qFm Notary Public State of Florida
Laura Townsend
ask• • hiy commission
Revised 11 16-2016 r x : o AwlodlrT * ?
�'' ) NH 173135
y o� •• d orrti Exp. 9/13/2025
STATE