HomeMy WebLinkAboutchange of sub contractor AW
JJ PLANNING & DEVELOP.tN
IENTSERVICES
BUILDINC, & ZONING DIVIS.10N
2300 VIRGINIA AVE PIFOUM
FORT PIERCE, FL 34982 APR 0 6 2022
(772) 462-1553 FAX 462-1578
ST. Lucie County, R-an-nitting
CHANGE Q)r, CONTRACTOR SU13
PLEASE,$[-.I.G(.-r ONE 01:J'LjLFq)L1_Q k.,1NC J:
_CHANGE OF CONTRACTOR-Change of Contractor is to
be si-a-mcd and notarized by the property owner.
and [lie new contractor ofrecord fur(he currentPentlit. A new permit application must also be ccinipletbd with
conEractor information and sigricIfUl'(2. A. new Notice of C,
for job VaILICS 011anience-nicrit ITIU-sir be filed in the new contractor's name
greater than $2,500 (57.500 if ABC'. CIMI0. A reco
commencing any work. T,h There is a $50,00 fee for the.Charge
TC-011 of Contractorrded copy must be submitted prig[- to
x CITANGE OF SUBCONTRACTOR Subcolltractur changes are to be completed by the gener,11
I n Contractor.
The new subcontractor must fill Out a Subcontractor Agreenjent Form. There is a SSO.00 fee for the Change of sub-
Contractor.
—CANCIELLATION 0), 1q,'RIVIII,
Cancellation of permit i. cance.'fati,)n of�'permit is acceptable only if no %vork has been done.
�; j-0 be signed and notarized by both the ownel. alld
Cancellation of the permit. ClUalifier of record. There is no fee for
Date: 6 —2
Permit Number: (02�— odd
Site Address:
StMz License or subcontractor 01.(wne Il(ler
License
State Licenseu—
easoll l'ur C".111M
Reason r D 6--.,
lation Ca
The undersigned doe'herebv
T"' I UL=e
itsofficers,--�a_g �
'19"ce 10 illd,-'Ivlif�and hold Jl,,rrn1Ie_
e t LILCie County,its
��.s�s=i I(_-71'.-
C3 Co
-is i r,L"' Crorn wiy mid�111 Claims oractf.oll 6or are reason, %v cl,Ls and employees e-08 fS, fees o r d it I m e 3 81 _S',� nPI1)3,ec3 from ar!
Or which rria).�Jri Cancellation 01- rise as a result of ibis clialigo. :)I*11,04-Init. A per milcillinor lye.cancel ed if work has been performed.
GINATU R L 0 1:0_\A'
smc of Florida.CrAlory of St. Lucie Coumv
The"'It 111-1 1fB11_.JMCr1[lv;l�acL"t—led-ed St2r." Cour;tyofst.Lucie
bcfi)i-e me this.
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E�o re Hannah E Moore
41", fy�fubhc State of Fl.prida N.-Otary Public State of Florida
Hannah E Moore
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PERMIT# ISSUE DATE T_
PLANNING & DEVELOPMENT SERVICES
1 . Building& Cade Compliance Division
o -
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
—Ehman Electrical Contractor, LLC have agreed to be
(Company Name.%Individual Name)the Electrical Sub-contractor for Adams Homes of Northwest Florida, INC
(Type of Trade) (Primary Contractor)
For the project located at 73 �� _
2� �,t'D'/t) �-
rtyax ���� �L 3(,�cr, t✓
(Project Street Address or Prope T I
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 SIGNAT('RE(Q�Wi -- _
S('A.CONTRACTORSlGNATURE- - ^ � --�(Qualifier)
W Bryan Adams Timothy L Ehman
PRINT IYANIE
__. .
PRIXT\A:\lE -- _
29179
____ 31748
CO(i\TI-CERTIFICATION NC.IBER
COUNTS CERTIFICATION NC�iBER ---
State of Florida,County of St Lucie ST LUCIE !
-- State or Florida,County of _ ��
The foregoing instrument Wass tined before me this N�f The foregoing instrument was signed before me 1his,.•!V ilai•of
GiG __,20� W. Bryan Adams �A —
zozTimothy L Ehman
�)ce - --- -
%rho is personally kno+vn-i or has produced a wha is personals known or has produced a
-- - -
as id liricalion- as idenlifica Ion.
_... _
-__.__-.._ STAdtP AMP
s ra oftY ar• u/Iii: - STSignalureofNotaryPdhlir --
P nl Name of N ary Public P ShJT'1l y��// Print Nee o Notary Public -
S ..... l
Zvi
��,u�m: .►a`°oo Notary Public State of Florida r
' = ?° �; Laura Townsend
� — My Commission
Revised I Ir16 2016 7-:,o *lF(106177 * ? c°A HH 175435 a
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