HomeMy WebLinkAboutchange of contractor7A-
PLANNING
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n&-ASJ. i_I�L� UN
CHANGE OF COINTRACTOR -- •Change of COnlractor is to be. sig;led and notarize f
and tite new contrac•(tir c)f rcCOrd tu[ file currettf permit A new permit atsplicution artu�t also be cpm let
contrac[nr- information and Sag c b� nc� property owner.
for job values t* niture. A stew' Notice. of C•d►nntencenlcnr nimi be filed in the new COntractor°sed tkt new
J ,realer than $2,500 (S7.500 if A/C Ctlange-out). A recorded c,aptir must be submitted
co+nmencirtg name
any work. There is a $50,00 fee for the Change of C naat"actor. Prior t0
X CHANGE OF SUBCONI-RAC-1.011 -' Subcontrac[cir change~ �fre to ltc con] !c ted by the r,
The new strbeonhaet.]a na+st till out a Subcontractor Atti-eement Form. There is a $50.00 fee for the Charade Sub -
Of
n ,encl-af Conrractrn,
of Sub
[,ANCFLIa.%"hION p>r !'F�1t'1�i17 - 7ltc• cancelfari,)rt of a peruait is acc4l,table only if nu work has bccn dclnc.
C'ancellaril�n of pet"At IN Ist be sigriell ;and nY�rari7ed by both tine otvncr' is cecptF i +o record. There is c fee
cancellation of the permit.
for
Date: _ �
-� Permit Number:
Site ACl(ll'L'SS:
OrIgi11:111 GC, subcontlaclor of i�t4t t� Stale License rL13Q1/� j�',��
y� �r 1, url;lcr• (Al.C' f.ik:c:nsc _
Ne>y C;(' suhcanuac[or -- . _, LC. t.lccrase
Reason fur C'rna eltaarorr — 2
I he----
-Krc I(I Inncru:iffy altd hold hirntless St Lucre County, its of[icc r,, a ,
cost, f8r2} c,r ddnrlZes arlair'� 1ipn1 ttny mid alf cimms of acrinrt tar any reason, uhacll nlay arise as ;, result or this ch;tng, of
li,n1[d4t,�r'ftirlikCOrlrlJl'r{11 Or c::ltcctlatl�:t tit" !,crtts nrtd employees from alf
9 t><rinrt A pet mif cnnnor he cancel ed if Is-ork leas been performed.
slr�,trL'RLCr:'Uu�V R nr;,Haart�uilllcr'j '- �__�
L,rR.ti tY)ii f or nv.,,l`,i ac ,r"i+',Ib rl
r'rtr`1lLfV1�?r1s-
y;J+S
The ;ti�IW,arn� 1n,ue,rrern u.l, a�uu�•1cJenr r•e i,,r, nlr d1i,
• Pcl I�rtu'nt r41t1�
or Yvi �� !• r, P ud d —
,,
1 �" z
sign hire of Not.ry vat,
W
�+�" 4+ r f7�ubrlc Stare W FlonOa
Hannah E Moore
7�'_ • , COrTImY�AOn HH 17
�aR� EaplresO/r01 D D95
r1024
Slat: of a (',,unlj ofsr farvlc C'1�1.4
r1: furl,tvl;lh )�tro+nrrnl uac uft k; ,i, [.dj:cd bcI ire rk 11b,
rvrn
r wh,1 ha, prkl.lced
S[An,rfureuflrsterT Rare
=HannahE
Ic State of ! �orloaMooreslon HH 017Dg,12024
PERMITO I I ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Cade Compliance Division
Ehman Electrical Contractor, LLC
(Company Nameltndividual Name)
the Electrical
_R (Type of Trade)
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to be
_ Sub -contractor for Adams Homes of Northwest Florida, INC
(Primary Contractor)
For the project located atLtd ,
(Project Street Addressor PropertyaxT
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.
iz:� "
CONTRACTOR SIGNATI RE tQualirieri
W Bryan Adams
PRINT KAHE - - -
29179
COi I�TY CERT1FiCATlOi1 i�G\�BER --"-" � -
Stale of Florida, County of St Lucie
The foregoing instrument etas signrd before me this 1 . day of
F .� "• ao -a� W. Bryan Adams
who is personally known 1 ,a or has produced a
as idealifica lion. a
Revised 11. 162016
zo : c IPYt 106177
7A '• d e
Icon 0
IMrSTATt: ��o�
STAMP
St R.CONTRACTOR SIGNATURE (Qualifier)
Timothy L Ehman
PRI\T XAW
_ 31748 ___
COt-NTYCERTiFICATIONNt'dIBER'—
Stare or Florida. Coantvor ST LUCIE
The roregoiag instrument was signed before Inc this f+ dal of
:tl , by Timothy L Ehman
who is personals) known Y-or has produced a
as ""n"nea ion
Signature of notary P 1:111e STAMP
sacra
Pr,ins Acme of llolary Public �•
ONotary Public State of Florida
Laura Townsend
' j M c t mission
O+^° 76435
Exp.911312025