HomeMy WebLinkAboutchange of contractor (2),, _. wjmfi�
PLANNING & DEVELOPMENT SERVICES
BUILDING & ZONfNG DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578
Fa
ELLATIOn
YLCASI tif;f,CC [ Ct L U1 11,
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�CHANGE OF CONTRACTOR — Change of Contt:lctor is In be sigtled ;end notarized by Ehc
and the new c:unh•ac•ter o1'record for fhc
contractor information and signilture. A ntcH`tNcif ticctlotf f'ointtuencement rttLLst be tiled to the new cotltracti owner•
eW Permit apltf[c.ttiott must also be corttpleted +ti[to ncta
for job %d]LICS greater that] $2,5{l0 (57.50(} if Aif' (-Onln_ nc A recorded if
COnhltc[lClna Oi 5 o, to
any work. ThcrC is a $50,00 fee for the change or Contractor. PY must be submitted prior to
x _CHANGE OF SUBCON7-RaCTOR -• Subcontractor changer ;tre to be corn lcteci by the rf
The rac subcantlllctar must till out a Subcontractor AS,reellient Foi•rn. There is a $50.00 fee 1'or (he Change of Sub-
-CANCELLA 1'Ip1\' O1 111:Et;«11 - ! he cance[fariort of a peull+t ES lCCC()tllblu' only if nu %�urk hzLy hcen (lone.
('arsccf[aEi,�n of [►trinit 1; to be signetj slrld noranTed by boih the owner is gcl)til l of 01'record ')'here is he fee for
Date: _ — � -
Permit htrttlbcr:
Site Address:
Or[gin:ll (i(', Subcontraclor ot'itixti 1�- _..- _ - State Licem-ic eL ?
err r l�lrildcr ���I� [-( t.ivvnse
lVe�v C.�C•, stthconri:tclf]L• �-' �Sta(c !-,icrn,e�.l� �7�;LC' f..iccn,cJi���
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Reason Jut Cilrl, Cl'.'tlloll
I he lirtdrr.4iunrri .l - r..._.r_
«x « rr, Lnnettuufy attd httEd ftarntle t St Lucie County, i(s of[iccrS. aSctltti and cmpt,tyecs from alf
cost~, f+;cs or dan4��rS r,ris+r,n tit)sn tlr!) ark 7iJ Cl,lints ctf acEinn fi)r any rr35ort, uh,ch ntay Ari,� as ,1 rc,uit of this chart �• of
Y' �aulticr,rr subeoru[acrtn or caricc[ltriron ter 1>ertnit A pertnit curfoot I)e cancel ed if work has been performed.
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Tlte![�Il.�,tin_ tu<u.rr:rst st:r,.t t��.:lctnl b:irr, mr the;
mat
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g ere nt Norun Date
E;_e_de:
`,c ale pl F pr�daE Mooremission HH 0 t'09'.'1.01%2024
rti�nt`[_ of t:iar;ta ('cuct7 of tit- Lar,rc Car,.ety
+�. 1milmOnk ,tnmrrrl uac a; k;,n4•_ dFel�,rr �'
I� d ro;ry klla .n r.:,
t 4 r who tia, pr kiuced a, D.
StArurfure ur lotur3 Date
=annahE
ic State of FlonaaMooreO-n HH 0170940 2(1
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 Namelindividual Name) the Electrical Sub -contractor for Adams Homes of Northwest Florida, INC
(Type of Trade) (Primary Contractor)
For the project located at
(Project Street Address or Pro Tax ID #)
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 wil I be advised pursuant to the
filing of a Change of Sub -contractor notice.
CONTRACTOR SIGNATI'RE (Qualirierl
W Bryan Adams
PRINT NAME
29179
COt',NTY CERTIFICATION NUMBEiR - "
Siate of Florida. Counts of St Lucie
The foregoing instrument stas signed before me this ! - day of
�tt'Gf� , 2,,, by W. Bryan Adams
who is personaly known Y, or has produced a
as idestificallon. A
STAMP
Pit2ameorNtAublie'� \\�111it1f1fi?f�
\CNN\\\\ SNRA S T
S Revised 11.161016 ; o MNH 1061T7
i rA '. d
.g'11411111 Him
j-Ac�dad
St B.COWRACfOR SIGNATURE (Qualifier)
Timothy L Ehman
PRI\T,NAIIE
31748 _ _
O—U,NTVCCRTIFICATi0_,WRE BER
State of Florida, County of ST LUCIE
The foregoing instrument -as signed before me this.. � day of
,2oz TimothyL Ehman
who is personals known X or has produced ■
as Identifies ion.
STAMP
SIvI811re of Notary P blic
Ariol Name of Notary Public
ors PI Nolary Public State of Florida
: `F Laura Townsend
'� My Commission
orr`° Exp.911312025