HomeMy WebLinkAbout22022415_26_30COUNT '
F L D R I D A—'
PLANNING & DEVELOP VIENT SERVICFS
BUILDING & ZONING DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578
1'LCASfi SGLC(-T C) L UE 1!i FUL 4ty[;;
CHANGE OF t:Oti7'ItACTOR — C'hangc of Contractor is to be signed anti notarize(! b � rile ro
and tire new contractor ot•record for file CUI• C111 permit. A r,ra
p pert} owner.
eu
contractor information and Signiturc. A new Notice. of ('orninencenicnt ntu-tit be tiled in fife new contractor's name
perm+E af,plicatton must also I>c completeil �ti-tth nett
for Job values greater than $2,500 (57,500 if A: (' C.hange-aut). A retarded co
conuncncing any work. The is a $50,00 fee for tilt Change Of C'out"actor• pti, tnu,l be submitted prior to
XCHANGh, OF SUBCONTKAC-I'0I2 -- Subcontractor changes are 10 be cum leted by the 1J
The new subcontractor must till out a Subcontractor Agreement l'+orm. There is a $50.00 fee For the Change of Contractor,
~ r Strb-
-ation o L1.,lllit O,t be igne!\it1' — to earneelfarir�n of a Iyertttrt IS ateccptable only II nn ti�urk I,atti been (lone
{'ancellation of perruit i; to be signed and nl�tanzed b} both the owner clad qualifier of record. There is no fee f
cancellation of tine permit.
or
Hate: _ _- (zy�z z_
—•�� Permit Number:
Site Address: —
Original (i(,', subcon[raelpr' or c,tvncr htnldcr S[,lie License rL13�s �
t C 1.11'4r1SC _
New (iC, atthrnnG•,tcl(tr .•��tate i-.iccn,e SL(' I,iccnse 3t7q
�—.
Reason f'ur('nileellatiott
TIIe urtdLrsll�Il�rf •inns 1...�.L_
costs, fec,t or dmlt lges arising f ofrl 11ny Hildt 111 cI aimsirlracitu,nat`�r any rc3son o+ hicll nut}taatisc�a5 ;t res((jl of lifts clta,: e of
y t,cnts and cmrklo}ecs rmr,1 all
�t*r11k�CWr/tiubCunq tc lur ur calleelfatlun O permit A permit ctIonot be. can er! if 14ork has been rerfarnted.
yj
SIGN kl Lit
Gt4E(O.VrN•t( T[.)tr fornr�t f;C'_ `*Pl,�irilb'c}
Riiil' fi>1M.6 .V
_ PrtfV71•igMIE �r��#h� E...{>f,y
Swcc of I'I,rricld. CU111t), of St. Luac C(hmn
rI1C tllltl,U+]IIL Ii1.0 Jfl'lrtl R:1C Rek1ho.--ledyeit l+Clare I]IC ra1N
2`
W• �, � �.,5,.€'.i lx,if110111II� I,n 11.1! [
as ID
f� ,n
StRn lure of Nnrun- Dart
Y,�lr7'ua41c State of F�pr,daHannah E MooreMy Ccmm1ss,orl Hai ii1'.,99Expiresr` -0JQ024
Srrr: 0(J-4kmt1a- C'0ud11 j of S: Lui rl ['Ril:-ry
I} : fnlh�k� lg rn.trinkrm %L- ackrowlodgd belure me tNi
h(y'C'66k
-_ally k.IursnrHily LWAA11 u,
t t r Who has j'r'kFllc td as 1D,
Mgnaturt of Notary
raV�'r'.# Notary Public State pr Flonda
Hannah E Moore
g p� My CDmmiss,on HH 01 7099
r�oi nix Expires O7r01W24
PERMIT 0 ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
Ehman Electrical Contractor, LLC
(Company Nametindividual Name)
the _ Electrical
(Type o(Trade)
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to be
_ Sub -contractor for Adams Homes of Northwesi Florida. INC
(Primary Contractor)
For the project located at ! r'o La( r_
(Project Street Address or Property Tax ID (1)
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.
COTRACTOR SIGNATURE (Qualifier)
W Bryan Adams
PRINT NAME
29179
COUNTY CERTIFICATIOA NV, 18ER
SINIe of Florida, Counts of St Lucie
The foregoing insiromeni nas signed before me ibis ?� day of
�rlr1 f 2 by W`Bryan Adams
who is personalty known YI—or has produced a
as idAlificallon y
Revised 11-16.2016
STAMP
`\\��I�IIN11tHipJr/
�G pLH27 F#e• ��
x '. c fiFy1 fool77
g•�A°jMad`~•`\pry
A&�S7ATt: � NOQ\\��
ffflHHll
SUR-1:0VTRACtOR SIGNATURE (QuafifierJ
Timothy L Ehman
PRINT\AW
31748 _ __ _
COUNTY CERTIF1UfF0_•i N['\l8ER
stale or Florida, Couriv of ST LUCIE
The foregoing initrumeol was signed before me ibis 41— der of
.20Z;sy. Timothy L Ehman
who is personals known ./ -or has produced a
as [drolifica Ion
STAW
5110alure oft�atary P11 bile
Prifl Name of notary Pnblic
.V" Notary Pub1iC $tale of Florida
Laura Townsend
My commission
' HH 175435
?ors Exp.911312025