HomeMy WebLinkAboutchange of sub contractor PLANNING.& DEVELMIVIENT SERVIC S
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S P J'�
BUILDING & ZONING DIVISION
2300 VIRGINIA AVE
APR 0 6 2
ORTPIERCE, FL 34982
(772) 462-1.553 FAX 462-1578 [ST- LuClie
CHANGF, or rrbv,-rin,,,-rA'OR. SUBCONTRAC
TOR OR CANCELLATION OF PERM
T
NLEASI SELECT`ONE OF J1-f1L1-()L1_0Wlt,4C J:
CHANGE OF CONTRACTOR—Change of Contractor is to besigneci and notarized by the property owner.
and the new contractor Ofrecord for file CUrvent Pcrrnit. A new perillit application rnt.lSt also be Conliplete(I Wit,, ne
contractor information and Signature. A. new Not, k
ice. of Commencement mwst bc flifed in the new contractoc', nan,
for job values greater than t'S2,500 (S77500 if A/C Change-out). A recorded cOPY must be submitted e
`7 commencing any work. There is a $50,00 fee for tile cil,111ge of Contractor. tted prior to
X CHANGE OF SUBCONTRAM'011 —Subcontractor changes are to be C0111p let
ed by the gener,11
The new subcontractor must fill Out a Subconiractor Ag contractor.
Contractor. --reenient Form. There is a Sso.00 fee for the Change of sub-
-CANCELLATION OF PERIVIll'—I'lle.cancellation of permit is acceptable only if no �vorl, h, el
Cancellation of permit is to be -signed and notarized by both the owner as becli done.
cancellation or tile permit. and qUalifier Of record. There •
is no fee for
Date: -3/30/2-2—
Permit Number: 2 (07— 6eJ
Site Address: Ci IT-- --
FL -?L1-*3-(
o 'I„- 17--icense
',If GC, Subcontractor ol-o�vllepjjlli Idol.
New GC,subcontractor State Lice.n.ie—U---"?:�'t)tflt�g7SLC License
Reason 1161-Cal1c.ellatioll cy A-r-
d do's�Ilerebv agree to�indeilm�if—�vald ,C7
The undersigned does lier- v agreo to hideilinif� rid I 11 13,ss',�t L
0081S, Fees oi,daningearising;
s from any and ill 'e:COLIVItY,its officers,agents and employees from all
C0llt1-aC(0l-!SLibcowjacto1-or cancellation orl)e Ofaction for any reasoll, which may arise as 11 resLill of'tllis change or
"Init. A pel,rnft cannot be cancel if%vork has been performed,
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PIRT,111' NAME PIZ INT NANI E A.,;applienblo)
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will ackIlt"Med-ed beforo me oii,
k,-,0\vi',�d,Ud belbre me this
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IS N1sxnslly knowl, fc[D.
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Sign hire of Notary Date
Slgfffifure of Notary Dare
Notary Public State of Florida
4/tio4ryeublic State 04 Florid .,'a Hannah E�oore
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Hannah E Moore I 4 . Hannah E Moore
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PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
ME
Building& Code Compliance Division
- - - BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
-Ehman Electrical Contractor, LLC _ have agreed to be
(Company Name..IndividualName) -----
the Electrical Sub-contractor for Adams Homes of Northwest Florida, INC
(Type of Trade) r�� (Primary Contractor)
For the project located at. 7 Zs 6zc ��_ I
(Project Street Address or Propetty Tax IiY/t) � � �4J-'
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.
CONTRACTOR SIGNATIRE(Qualifirrl SUIR-CONTRACTOR SIGNATURE(Qualifier)'
W Bryan Adams Timothy L Ehman
PRINT NAME — —
_-. - PRINT\A:1(E _...._-_..._._
29179 31748__
CO['NTI'CERTIFICATION N'Cd1BER— _____ _
CO[VT1'CERTIFICATfON N(diBER —
State of Florida,County of St Lucie ST LUCIE i
--- State or Florida,County of
The foregoing instrument»ass tined before me thl,? :day of The foregoing —T i g g instrument was signed before me this
..,..._clay of ;
2315) W Bryan Adams
---- -- 207�by Timothy L Ehman
e•ho is personally known.-or has produced a — who is personalh known or has produced a _
as id lificalion- as idenllfica Ion.
---- STAMP
s GGt !
at orN ar u tic STAMP
Signature of Notary Pdblic
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P ni Name of N ary Public \\�111111111NIt�/f///
Print Name of Notary Public 1
%
Notary Public State of Florlda l
Laura Townsend
My
Revised II�16R016 Commission
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