HomeMy WebLinkAboutCHANGE OF CONTRACTOR PLANNING & DEVELOP.NLIENTSERVI
BUILDING & ZONING DIVISION RECF
_C��Ivr-D
2300 VIRGINIA AVE
FORTMERCE, FL 34982 7A APR 'L'022
itting
(772) 462-1553 FAX 462-1578 ST. Lucie county, Pen, 3
CHANGE OF CONTRACTOR SUB
PLEASE' SE1.1(_rLQhLLL- 0 ]:I.LJL:'_F0L1,0W1NCJ:
__CHANGE OF CONTRACTOR—ChanLge of Contractor is to be signed and notarized by the prop'lorty Owner,
and the new contractor Ofree-Ord for the cL
contractor information and sic, 11'rent Pcil-nit.. A new Permit application must also be completed with
new
,,nature. ik new Notice of Commencement 1111-IS1 be filed in the new contractor's name
for job VaILICS greater than $2,500 (S7.500 if A/C Change-011t). A recorded COPY must be Submitted priol- to
Conlillencing art), work. There is a $50,00 fee for the Change Or Contractor.
X CHANGE OF S UBCONTRACTO11 —Stibcon.vactor changes
The new Subcontractor must fill Out a Subcontractor AgiVe are to be C0111PIeted by the -eneral contractor.
Contractor. __ "lent Form. There is a $50.00 fee for thoe Change of Sub-
-CANCELLATION OF PERiN111, Cgllcerfafjon of-�L 13el
CancellatiOn of _rll it is acceptable only il'11() work has been. done
permit is to be sig an notarized by both the own
cancellation of the pel-I mit. nL!dd owner and qualifier of record. There is no fee for
Date.:
Permit Number _ZJ67-6Cf55__
Site Address: 5'I tr�
L--toLS�rE4—rRobe—
Orlai Lrador Or _.stale.Licerisc_e7
eiv GC,sube-onu-actor License
SLCI_iccnsc 3t749
Reason 1br Cancellation
6C3-4
"lie undcrsi�_,,iicd do—ci hereby_al-,�c to_:
-=1n
The undersigned Mci hereby hgl-ec to ind,(li:lify;Ill
11drilltegs'St Lucie County, its offloct-3,a
7,77 gerasand empll.)yo.cs Fran,
003ts, Fees or dania,_� S Flom any aod all cllinis rlrac6on for any aft
Or reason, which olay Irise as n result of'61is C11111ge of
c'11cel I'll!i011 0'Permit. A Perrnfl clitillot be canfqlJed if work has been n performed,
�s_1(ATW,r R C,
SIG
WATUREGENE C:(
NAMG app;io,b lo I
rRiLiTt�
S:u(corl-"olicld.CrAWYof S1.Lvci�.Cot),!(v
of 1:406(fil.Cauntyofst.
Id7z Ln�crurotmtzl,.,wk.mvitdved bel'ure me[hi,
of
TfPJ __ aPse0Mo liaI13 vl ro ulc
or �'6 h frodU�CO
_T Eh
%vlois I
ca
. r wbo has pr iduced
us ID
Sign tare of Notary
SIgnmurcorNotarT Date
ryf ubl�Sate of FL.r"Ja Notary
Pubh�State of
Hannah E Moore
E Moore
My 0mmss,.n H8 017099 Hannah
�., 's
0 9_
pQ M -M -HH 70
x iip, '0, 0
= pires 07/Oif2O24
07 MY COITIMIssion HH 01709cg
�j"- 1yeubbc State Of FLorida
Hannah E Moore F'��-_ N_Otary Public State of Florida
'ib
My Commission HH 0 17 099 Hannah E Moore
:, d;: es 0"2024
E es 07 12 24
Of F� Expires 07/01/2024
i
PERMIT# ISSUED TE
- 1iw PLANNING & DEVELOPMENT SERVICES
Building& Code Compliance Division
• - - BUILDING PERMIT RECEIVrED
SUB-CONTRACTOR AGREEMENT APR Q 1 (022
ST. Lucie County, Permitting
-Ehman Electrical Contractor, LLC have agreed to be
(Company Name./Individual Name) — -the Electrical Sub-contractor for Adams Homes of Northwest Florida, INC
(Type ofTrade) (Primary Contractor)
For the project located at 5'Yq 3 Fl— 31-(?YI
(Project Street Add�eorroperty Tax ID If) --"
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 SIGNATURE Gay. U
(Qualificrl -
SUR.CONTRACTOR SIGNATURE(Qualirter)
W Bryan Adams Timothy L Ehman
PRINT__. NAME PRIST\A:11E
— _.. ..
29179 31748
COUNTY CERTIFICATIO(\ L4'%IBER --- -- ------- - ---------------.-----
COUNTY CERTIFICATION NCdiBER
State of Florida,County of St Lucie ST LUCIE
------ State or Florida,County of _ E
The foregoing instrument nas signed before me this day of The foregoing instrument was signed before me tbis,7��dar o[
CiCG� Zo2h W. Bryan Adams -
-- -- ------- -------��.__ � ,z0-?by. 1mothy_L Ehman !_
who is personally known 1—or has produced a _ who is personals known or has produced a
as id tificalion. as idenlifiea Ion. - --
_... .. . ---.---__—._.. STAMP
Si at otN ar u�Iic STAMPSignalure of Notary Public -"
lava
P Fit Name of tr ar)Public \\\\\\CNN J1P Stwo,,,, Print Name or Notary Public
W P90, Notary Public State of Florida
* r �; Laura Townsend i
Revised I I!161016 �} K,v , My Commission
Z :Z #IiH 1061 y dt' HH 175435
O:mod d lT y y '>orr�o Exp.9/1312025 f
i 9� yAo�ded thin �e�. T ye- rr. 1
" STATE ` NN�\
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