HomeMy WebLinkAboutchange of contractorJ .ti PLANNING & DEVELOPINIENT SERVICES
BUILDING & ZONING DIVISION
2300 VIRGINIA AVE
FORTPIERCE, FL 34982
(772) 462-1553 FAX 462-1578
O
PLEA SI. SC:Lr(-1 t.t1 h iii: I f� f t)Ll. u I!vG:
CHANGE OF CONTRACTOR - Change of Contractor is to be signed and notarized by the
and the new contractor oi-record f'or the current permit. A new permit application must atso be cotll lete i
property o►vnei.
Contractor information and;igliflture. A tiew Notice- of (-ortlrllCrtCeill('1)t must be filed In the new contractor's namC
for job values greater than $2,500 (S7,500 if A'C' Change-oute A recorded copy must be submitted orcontractor's
4rtf1 nit►
conu►t�ncing any work. There is a $50,00 fee for the c1lange or Contractor.
prior to
x C'IIIAtNGE Ol" SUBCONTRACTOR - Subcontractor changes are to be cons leted by the general
Co rac subcontractor nlust tit! ottt a Subcontractor AV+reement Fornl. There is a SS0.00 fee for the Chanaetof Stot
Contractor.
s u b-
CANCELIa.1il is IV be ignetPER\i17' - 1 be calleellatiOrt oft pennit is acceptable only if no mrork has been done
('ancellation of permit a Io be Ci�rnCtl and notarized by
cancellation of the permit. both the owner and qualifier Of record. There is no fee for
Date: zY
--- Permit Number: 1 b tl- U 16,7
Site Address:
Ortginrll GC, subcolni'aclor Or o%%ntl"+bllildcr St,l[c License rL Al�1r'3( 1.C, IWe
iccnsc __
New (iC, suhrt)ltuaclnr — _- -. L( License 31 �49'
Re:Fsoil furCanccilalioll
l
'1 he tmde'rSli�lle`ti .inns 1�.,-.L.
rrlaetttnity ,tnd hold hartltles4 $t Lucie C•' tufty, its Officer,, a cnis nrld cmplo— yecy (rim all
costs, fee, or ftiltTLl cs arising flMr, tiny and all clarnis frf action ft), any reason, permit c+R,.hich ma}' aril. as a rf sutt Ot fhiti change (>t'
Cil71lIZFCfQt'�titIbCU11IlHCFOl' or C,knCCllatll7rl or"tkrrnkt Ann,rot be ctlncet ec! if %tiorf; has been performed.
'rCrtlltL fti' Uu VFH it+r ut�'nCrburltlar`I Slr,N,Yl'�CE�14E
r
fCPRiii ac �r�Fa4•,rb'ct
Swtc of i'lint(fa, C'atnty' of St. ! oc:rc C[wun
'Tjhe 6,Ifi i4111L it, p'%Jrrcnl ua� at$1x , led,er[ valor, mrAt,;
w— ��' �� ���+4ttcF is �nouall} lnuhtt W tu.•
as !p.
Sign hire of Naran, Rpm, -
Date
4 /�ina4th E Stale d F4orWa
Hannah E Moore
My c: ommrss.0n NH 01'09b
ora Expires07,01r2024
State of I'wrtcia. uourltyortit- fau•ieCowLay
t}+e follps<•nrg r t. r tmc�rtl u�; u-k^o+tiiad�cd
(1?�daY n1/!y4 C btlure rac tlla►
- .-- lursr,nAliy I.noKrk q.
r c r wlh, ha, pr ucxd _ as f D
SlgnrlureorNotary I to
,�4+ Notary Yub4c Stale of FIOr da
Hannah E Moore
�'- p• My v.�1n,t,Ission HH 017pg;
ERprre.07.01r2Q24
PERMIT 0
ISSUE DATE
�,� PLANNING & DEVELOPMENT SERVICES
� xs
Building & Code Compliance Division
- BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Ehman Electrical Contractor, LLC
(Company Name'Individval Name)
the Elscllical
(Type of Trade)
have agreed to be
Sub -contractor for Adams Homes of Northwest Florida, INC
(Primary Contractor)
For the project located at�'��
(Project Street Address or Property Tax ID F1)
It is understood that, if there is any change of status regarding our participation with the above mentioned
project, the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the
fling of a Change of Sub -contractor notice.
CONTRACTOR SIGNAT{'RE (Qualifier!
W Bryan Adams
PRINT NAME ---
29179
C01'Nr1' CERTIFICATION nt hIaER - --
State or Florida. County of St Lucie
The faregoing instrument %assigned before me this tV day of
bn { t zoo b) W. Bryan Adams
who is personally known Y. or has produced a ..�
as icirltirktiion_ .
Revised 11.16.2016
STAMP
S
.'�0
4& i
O : o +IFiFi ftYf717T
.s ..•yao�d `�; r ;
STATE&,;,X\\'
St B.COVTRACPOR SIGNATUR$ (Qualirierl
Timothy L Ehman
PRI\T NAME
31748
CO_VNTI- CERTtFICATIo_bi Nl'dfBElt
Sure of Florida; CDuatyof ST LUCIE
The foregoing instrument was signed before mt this. day of
�r .20 �, ty 1motgy L Ehman
who is personal!) knows IV___or has produced a
as Edegliflta ion.
STAW
Sitnalure of N01mry P He
Print Name of Notary Public
�•+ Nota y Public Slate of Florlda
Laura Townsend
t ' M HN 17'54351Qn
?orn Exp. 911312025