HomeMy WebLinkAboutchange of sub contractor PLANNING & D-EVELOP.NLIENT SERVICES
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BUILDING & ZONING DIVISION
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FORTPJERCE, FL 34982
(772) 462-1553 APR 0 2022
- 78 ST. Lud:e County,
i-1--rmit]tino,
CHANGE OF CONTRACTOR, W
CANCELLATION OF PERT-
PLEASE SELECJ-L)NE or 1jjLF-()L1_0\N,INC,:
-CHANGE OF CONTRACTOR-Change of Contractor i
is to be.signed and notarized by the property owner.
and the new eorlil'act0l-Ofreeoi-d for file CU-Trent Purnit. A new Permit application
concracLor information and signature. A. new Must also be collipleted %vith ne"
for job VaILICS Cv Notice of Commencement 17111"1 be filed in tile new coil ti,actor,s name
I
C0111111C116 rea-ter that, S2,500 (S7�500 if A/C Change-0110. A recorded COPY must be submitted priur to
1`9 111Y work-. There is a $50,00 fee for tile.Change of Contractor.
I X CHANGE 0J."SUBCON FRACT011- S;ubcontrjc.t0r changes are to be Coln plated by the (yenerill Colltrac,01%
The new subcontractor must fill out aSubconfi-actor Agreen,
Contractor. -- ent Form. There is a $50.00 fee for the Chanoe or sub-
-CANCIELLATION 017, J)1s[ZM11- -i-Ile
to be si ()fa i3ermit is acceptable only ii'llo ""k has been, done.
Cancellation Of permit is i. 191led and notarized by both the Owner and (JUalifier of record. There is,no fee
cancellation Ofthe Permi for
Date:
Permit Number: 'O(C)7-61116
Site Address:
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Origin:11 C. —Stal:c. License
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Licclls
Reason l'urc,"Incellation'-- CoA+ 4-br
The undersigned d<1as hereby agreelo
c-081S, fees or daiml-oe "glee 10 fldclllnif�and tl()1c1 h3fi'llIeSS St LUCie County, its 0f'J71CCr3,I or agents cLn(1 employees From all
si'19 GOrt,arly a7?d�111 C1,1�111's clractft n Cor ally reason, %vhiell n-1,I).ads
c"ll"i'lli'110110riv.rinit. A perm e as a result of'this clljng;�(:)I*
""llot 1)'e canfcOed if'York has been performed,
G ti`r1"rURL`OF U I I
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PIRI',�11' NAmrs RACT R(or ri6%c
smc of Florida.CNICIVY of St.1-licie.County
Tile Star".CL(F;ari<1a-CuufityufSt.Lu,te.Cowity
kerory me tjti.� .fl
%-z ackno%vitdged btfore me thin
110
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Sign (tire ilrNoian.- Daic Qfla�
S(grulfurcol'Notary Date
eP ZkV;t", rYiPublic State 01 Florida
NOtary Public State of Florida
W State
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Hannah E�oore
My
Commission
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TF, Hannah E Moore
MY COITImission 1-11-10 1 709C�pr11-1P Expires 07tolf2024 CW li� Expires 0710 1 r2024
My CO-misSion HH 0 17099 Hannah E Moore
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PERMIT# ISSUE DATE
�i - - - i PLANNING & DEVELOPMENT SERVICES
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Building& Code Compliance Division
i
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
Ehman Electrical Contractor, LLC
-- have agreed to be
(Company NameAnd ivid ual Name) `--
the Electrical Sub-contractor for Adams Homes of Northwest Florida, INC
--� .�� _
(Type of Trade) (Primary Contractor) "—
For the project located at If 3 5 L u
(Project Street Add or Prope4 Tax 1D fl)
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 SIGNATI•RE(Qualifier) SUR•CONTRACTOR SIGNATURE(Qualifier)'
W Bryan Adams Timothy L Ehman
PRI\"r NAME ------'--_ i
PRINT\A:IIE
29179 31748 `
COi i\Tl'CERTIFICATION IBC\IBER •----- — - - ---------------------
COL�NTI'CERTIFICATION N[�IBER
State of Florida,County of St Lucie ST LUCIE
---- State or Florida,County of _ �``-�' I
The forcgoiog(nslrumrnl teas s enrd before me Ihls30 day of The fo rgaiag instrument was signed before me this`7t�'Isl'�p{ r
zoZZv W Bryan Adams
�- _-- — ---__-- Timothy L Ehman
who is personally known ,-or has produced a _ _ e•ho is personals known j or has produced a
as id tiftcalioa WrnIon.
STANIP
Si at r ofN ar' u lie J4-c�T ` STA�1P
Notary Ptfhlir -
P nt Name of N sty Public \\\\111111Mt�j/// q _
Prinl
t;PRA STi, Name of—NI ry Public
.�� ,•o�MISSIp ii -
�� �G ii 2740�•, ��
=ovaf°�ok Notary Public State of Faorlda
� Laura Townsend
Revised 11116,2016 '*S ��' 'A` MyHH1 Commission ;
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