HomeMy WebLinkAboutchange electric subCOUNTS }
r L o R t D n-
PLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION
2300 VIRGINIA AVE
FORTPIERCE, FL 34982
(772) 462-1553 FAX 462-1578
ELEASJ C L 0r ] L rot_t_ � true:
—:�CIiANGE or t CONTRACTOR — (`liangt: of Contractor is to be signed and notarized by [hc propert), and the new contractor r11 t'ecord for the current permit. A neu permit aplslication rn{fl also be completc(l u, o llel.
cornractor information and signature. A new Notice of A ncvL permt'nt mtt_st be tiled f y p p }owner.
for job values greater than $2,500 (S7.500 if A.:C Change -out). A recorded co nth{ new contractors name
conl[uencing any work. There is a $,%,00 fee for the Change of C'ntttr•actor. �} tnust be submitted prior to
X _CHANGE OF SUB CONTRA CI.OR — Subcontractor changes are to be corn leled h
The new subcontractor must till out a Subcontractor A��rt ement form. There is a $5p,00 fee for the Change
Contractor. ge of Sub-
—CANCELL %I ION OF PERMIT'— I -Ile cancellartoll of a peruut Is acceptable only it no cork Ka% been done.
Cancellation of per[uit is to be signed and notamed by both the 0%ner and qualifier of I-ecord. 'There is no fee For
cancellation of the permit.
Date: �ZL
— Permit Number: _21 ,0 J6 /
Site Address:
g-, ncr Slate 4n;ccontractor or riCLQpy', fl C` I. -
State I-"iccn.e L( Licence 304
Reason fur C'aercllatron
- - CFO(,, ul ntaemnifY and hold harmless S' Lucie C-ouilty, its ofti 'ers, at;cnte And employees fmnl all
posts, fire or d;lnu�gcs erisin� frOrrl arty and nit clAimS oraction fur any reativn, which nta}' rrrisc as :i resuit of this rltangt• rot'
irrtit�cwr�su6cun(ruc(or or canccllatlpn o► permit r► permit cannot he canceled if work has been performed.
til(.4,�'rt;RL" Ol" U'1A+.Vf: R I rlr nK1lerbuNd�rl Y �_ ..
S1Cir,=AfI±RE GENk .
CON rRACF[.)k for nca riC', i< appricnb CI
PRiriT PiAh;T-,
�. _. PRINT NNmE—f l
Stuic of I'!nitits, "111ty of Sr. I. were L'ovlltti
Tile li�]tillbill_L' 1flprJl7ll'Irl u;rr 1CJ�t� ,;IcJ�nl h,r�,r nit iLi+
l 5 d.ly �t `rJjllcl ,
n fvrenrNuwn' Date
y %�nr�ubrlc State of F4or,da
Hannah E Moore
MY Commission FiM o!'u9{.
yor FL ! Kp res 07r01.Q024
]Idly 01 h7.xida. ('ounty Ors, I-tii le Coil'ity
!l+e r lh�wrag uF.lrtl I'll «c acknowledged bilure mc. th16
"f" •(/4-`7 '}
elf ��.4h�.—,.
wtl.,r. ! y
_ Iursr, .xII : rhh+ir I.
e r w11 Ila, pr ucad 'o In
SIgnrrurc of tiolary '- � re
=�zo�
_ic State of FlantlaMooresion trH 077ogg1r2t724
PERMIT # ! 1 ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUBCONTRACTOR AGREEMENT
Ehman Electrical Contractor, LLC have agreed to be
(Company Name1lndividual Name)
the _ Electrical Sub -contractor for Adams Homes of Northwest Florida, INC
(Type of Trade) (Primary Contractor)
For the project located at _ J o4z
(Pro)ect Street Address or Property Tax 1D 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 SIGNATURE (Qualifierl
W Bryan Adams
PRINT NAME � — --- -
29179
C01-\TV CERTIFICATI01\ NL AtB5 !-- —
State of Florida, Count% of St Lucie
The foregoing instrument tiassignrd before me this !. dayaf
�-cbr^7 2046t W_Bryan Adams . _..-._ .
who is personally known a has produced a —
STAMP
`,o--5NMSr 1
SL'R.CQYTRACTOR SIGNATURE (Qualifier)
Timothy L Ehman
PRINT NAM It
31748
COL',NTV CERTIFICA_TION Nt'dIBER
State of Florida, County of ST LUCIE
The foregoing instrument was signed before me this. j dal of
,20 TimothyL Ehman _T
who is personalh known X.—or has produced a
as Idraliflcs ion.
STAMP
Signelurt of Notary P btir
P�a_uu
ripl Name of t\otary Public
�,r►e•oe Notary Public Stale of Florida
Laura Townsend
Miy Commission
FIH 175435
orr�o� Exp.911312025