HomeMy WebLinkAboutelectric sub - updatedCOUNTY
. t L R I D A
PLANNING & DEVELOPMENT SERVICES
BUILDING & ZONfNG DIVISIO;ti
2300 VIRGINIA AVE
FOR'I' PIERCE, FL 34982
(772) 462-1553 FAX 462-1578
YLEAst_ SL:LEr. f_c.IN[ c)l 14� rl)Ll.
—CHANGE OF CONTRACTOR —
C'hange of ColttrA pe is to be signed and notarizec! by the r0 t
and the nc►t- c0nh-actilr of-rcct7rr! for fhc cu]'ren! perrlti4- A ncu
contractor- informat,un and signaltily. A nc" Notice of Co►rtntencentt nt ntust io tiled in [lie new cipletetol'so aie" permit i<pphci<tion must also be CnrttpleEcd stil[h ncu
for job talues arealer than 52,500 1S7,500 if A:'(' Change -Out) A recorded cup}° ]must be subntitte
conuuencittr }i:
n arty work" 7'hC'e is a $50.00 fee for the Cll;tnge or C'nntractor• d prtur to
x C'Iubconu to SUBCON7 RAC 1'OR -• Sttbcontraetor change; arz to be contitic red h� the rreneral
o rac subcttntl�lctur must till out a Subt:onfractor Aor"mcnt Form. There is a $50.00 fee for the Change of Sub-
('Al\C'FJrI,A'1'Ipt\ {)!: 1'1?RlN11'— l ltr cxnc'e'flarialt of.k lscrttl't kS acceptable only if net t'•ork ha, hren ehtnc
Cancellation of permit is to be signed and 1101irized by bath the 0tt;nt:r and qualifier Of record. '['here is no
cancellation of the pel•mit.
fee for
Date: _ _
— — -- — Permit Number: -0
Site Address: 0 -
Urigill:ll (i(', subcomi-artor Oi' uun+ I'll; lifor - Slate License eG
New (:iC. subcctlltl:tclt,r .� State t. iccne ����
-SL(' l,.iccn,e
Reason fur C'an,ellatrolr
117,
coils, fee, ar door igc•c ttriSin� lion: anti,audtal; I la;ntste f uc ► ,'tfW anylre3son 0 hit tt yy. its tlrlscslsagrt,Ul[ ut iE plch."s rrnm;tlf
Cl;[i[[1CIJI /�LtbCUrllrJ -rr,l in c;ur�eff,lilcn (If JV"Ink A pel-mil carlltot ttr cancer ed if work hats born
K 1
perfornted.
tile.. NFL'ItL- r? O'A'�1i R l'rr,
Slfr �r..41 URE . , -! 1[G"E,1 — —
rt; T t.; C'�,�TR,1r'rUftr�rrn a rTi , . at .—
r l apl,tii,b,�]
talc ui I:t,mtfj- Cotlnlyof si
lire ?r.ILxtwr� it=ar;;rrcr.t ,.:t, i�krtt* Icl�,nr I+ei,+r; her i6i.
w: ��, �?'YI.,SSwli� j,[rsgnllt4 €twsyrt w irl�
4r w� -f Isf�
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Sign furs of 1\r)rgn• �
}ate
nFL
ublrc State of F�zntla E Mooremrsson HH L' t;:}9.e7;012074
Seat; of 1=i�srila. t`ourP/ {riSi. I_u, rc Chu'eh�
fif+: {fnllnkq;�h,tr,ttnrn,-rt ux:,, --- 511 �—;.h,,r+prrsr•r�l]} €„osc,s it
t, r whtr ha, pr,ducrd
St ru,lurcurNotnry � Dare
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=PubhCht State or FJonda Mooresron HH 04709g0[rr024
PERMIT #
COUNTY
-f L () R I 0 11
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
if
of Trade) _ — (PrimaryContractor)
For the project located at {,d[,�_
(Project Street Address or Property Tax ID fit) T
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.
CONTRACTOR SIGNATt RE (Qudirieri
W Bryan Adams
PRi.N'T NAME
29179
COi'NT1- CERTIFICATIOR Nt-dIBER — ' V
Stale of Florida, Coact% of St Lucie
The foregoing instrument n assigned before me this day of
20? i tey W. Bryan Adams
who is personally known !IL or has produced a
as idriblificstiod.
STAMP
I
I Name of R rS Publ[c ,�1001111tlrRjf�/
� 5pRA Sr
•`
<l
Revised 11 16201(r z :, o 106177
�A&-bncL'ndB i
lfllllt 11�'\\\\
. - f7�d,�� ��rnt�►2�
st ft•CONTRACfOR S�1/GNA'rURE (Quiiirier)
Timothy L Ehman
PRI%T NAME
_ 31748
COI ..VT1' CERT[FICATION NUMBER
Staie or Florida, County of ST I_UCIE
The foregoing rostrum*ol was signed berorc me this � � dot of
2�,• Timothy L Ehman
who is personalb known IK— or has produced a
as [denli"co ion.
STAW
Signal ore of Notary P He
Print Name of Rotary Public
or► •+� Notary PuEi(c State of Florida
Laura Townsend
My Commission
HH 175435
am Exp.911312025