HomeMy WebLinkAboutCHANGE OF SUB-CONTRACTOR 4- W
PLANNING & DEVELOPIN
L�Lj�--l'i L-m-t4i'L. IENT SERVICES
BUILDING & ZONING DIVIS.10N
2300 VIRGINIA AVE F7RECS-:11-VED
FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578 APR 0 6 �;22
ST. Lucie COL-inty, i-<ermittinq.
CHANGE Or CONTRACTOR SUB CANCELLATION OF PERMT J
PLEASE' C - OFW
., ) q1: I'Ll L-f-O -0 W w c,:
-CHANGE OF CONTRACTOR-(:harige,-or Contractor is to be signed and notarized by the property Owner.
and the new conil'acl-01-of ree-ord tbj-(lie CLIFT.-Clit jacri-nit. A llevv permit application must also be cons let Nvitll I,"%"
contractor information and Signature. A, new Not-
Ice Of Commencement uIlLsir be filed in the, new contractor's naurle
for job vall.[Ci greater than 1'2,500 (S7.500 if A/C Change-0110- A recorded COPY Ilius( be submitted
coll"llencilItcZ aL'Y work. There is a S,_50,00 fee for the Change of '. Prior to
Contractor.
x CHANGE 01. SUBCONTRACTOR- Subcon.tractor changes are to be completed bv the -leneral collt.ractol-.
The new subcontractor must fill OLIf a Subcontractor At,
Contractor. --l-Cenient Form. There is a$50.00 fee itor th'e�' Change of Sub-
-CANCELLATION OF PhANUT- rlle-cg
Cancellation of permit I,, to be signed nce"farit)" Of�'Permit is acceptable only if,no % 01-1 ,as been done.
Qualifier of r is n() fee for
I 'led and notarised by both the Owner and QUaliF v <
cancellation of the permit. 'There
Date: -3612Z
Permit Number: 2 I&2—
Site Address: i epee Fi, —3,1re*
0 11-111 GC, subcoilti,aclol.01 License tle__
-.1ke.
vzw CSC, "11heollu-"Ictor
Reason fiur c:1-incellation CC.)-A n�
c•asis fees or danntless St Lucie Front any and all cl,1jl11.s(Iracatn for any ts officers,a.f ents emplL.)y0es Crain. re`s'on, %vhich 01R)'Iiise as ,I result of,(ibis change 1)1,
cotttracWrrsubconttacror g all
or"ll"llalioll of-permit. A permit C1,11,10t lye cancel
--- ed if work has been performed.
SIGNATURE GENE N F
61
Six-eof Flori(lzi.Court j ofst.Lurk C'otlaty
The fo)[olk-ing,
re me(his
W. R,--ftd- am-&vh,)is PC11011alh krio,Ai r- III,: -T
or wrl-, prod i ---.
IL as fD. Ito i.<pc-
I L wh()11 S p iduced
di ID
IL
Sign (tire of Not.;)ry
Date Sign"Lmurc or-N,otary
Dare
41 2 Buhr t State of Florida 0 e Notary PUblic State of Florida
Hannah E Moore
H
My COMMS&on HH 0 17099 Hannah E Moore
MYY
COMMisson HH 0 1 709g,
a 11� Expires 07/01f2024
Gi F, Expires 07/0112024
PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
2 Building& Code Compliance Division
0
- — 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) Q (Primary Contractor)
For the project located at O Z A,,ft__(zq - 4
(Project Street Address or Property Tax ID Et)
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
Ming of a Change of Sub-contractor notice.
_- � —
CONTRACTOR SIGNATURE --(QualiGrrl SUB-CONTRACTOR SIGNATURE(Qualifier)_
W Bryan Adams Timothy L Ehman
PRINT NANIEPRIXTI�W--'- —
.. .. _...._--------—-
29179 31748
WI NTY CERTIFICATION NCFIBER COi;VTI'CERTIFICATION N{A1BER -
Stele of Florida,County of St Lucie ST LUCIE
State or Florida,County of �-{��
The forcgoiog instrument viass�nrd before me this day of The foregoing(nstrument was signed before me this /'�u'dat-of '202Zts W Bryan Adams
l - ----- -------- - /�a�-�� ,zo_ l Timothy L Ehman
who is personall)•known _ter has produced a who is prrsonalll knon•n or has produced a _
es id tificalion. as idrolirtre(on.
-.... .. _. .- -- - STAMP
Si a r of N ar- u�He STAMPSignature of Notary P blic -
P nt Name of N aq Public SP SZ/,// Print Nee o Notary Publie
cry i�
ONO
Notary Public State of Florida
_ Laura Townsend
Revised I V16.+2016 - a * y; , My commission 1
Z ,c #11H 106177 +? ooE' HH 175435 3
5O�.• d 5 y ain EXp.9/1 312 0 2 5 i
i 9p�•yAo�ded ficO ���.' Q�� A...a'°�-c+�r ;
�b/ic•Unde .•