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HomeMy WebLinkAboutSUB FORMSPERMIT # ISSUE DATE PLANNING & DEVELOPMENT SERVICES Building & Code Compliance Division --- BUILDING PERMIT SUB -CONTRACTOR AGREEMENT G have agreed to be (Company Name7In4ividual Name) the 1�_WA—C r✓ __ Sub=contractor for ylra Bt,1,►1dwd (Type of Trade) (Primary Contractor) For the project located at i�uvir, Rid,. - 3�h3 ��7t�2-ono- a, bC1`-1-S (Project Street Address or Property Tax ID #}. 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. COi RACTOR SIGNATURE ( alilier)' SUB -CONTRACTOR SIGNATURE (Qualifier) J -(3yyN 6rozck PRINT NAri EZUMX)C� PRL�iT NAME . COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER State of Floiida,'County of State of Florida, County of�`+�.. The foregoing instrument'was signed before me this day of The foregoing instrument was signed before me this day of 20+, by vNI11'-i'nOn t,.A�ro2 �l i' 20? , by,'ak who is personally known)Lor has produced a Lyho_1S personally known ✓ or has produced a i as identification. as identification. oOs�y POB JAM L HAMER !/ Signature of Notary Pub ' STAMP JSiature!orNotary Public * * Y COMMI IF G 089122 EXPIRES: Apdi 2, 2021 �C BOne�1N Budget NOIajSV9S(`k/�A Print Name of Notary Public Print Name of Notary Public BRIANNA GRAHAM o: :�% MY COMMIS510N #GG089105 2. EXPIRES: APR 02, 2021 Revised 11/16/2016 ry "��� Bonded through 1 st State Insurance PLANNING & DEVELOPMENT SERVICES • Building & Code Compliance Division BUn DING PERMIT SUB -CONTRACTOR AGREEMENT have agreed to be (Company Name/Individual Name) the �1VC+ �,�CSub-contractor for Crypt ofTrade) (Primary Contractor) -, For the project located at (Project Street Address or Property Tax ID #) 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 jphange of COITRACTOR SIGNATCR (Qus or) -YaNn PRM NAME (LI 4q COUNTY CERTMCATION NUMBER State of Florida, County of S-�,�;+ c i t The foregoing instrument was signed before me this 2�day of lQJ1 Ci1/� . zp2vby _J_17h(% Pr("0 v-1lroz . who is personally Imown Xor has produced a as identification. STAMP COUNTY CERTIFICATION NUNIBER State of Florlda, Coupty of The foregoing instrument was Sig before mo this da of NI /Ch ,20Lby h)1i V2- who ersonaliy known prodEa 16 We on. +•... 11111111 14lIH1111` S . 0:J Print Name of Notary Public Print Name of Notary Public - n 3 a, 777-7 O = W BRIANNA GRAHAM c NN Q- J„nwuuury � � � D MY COMMISSION #GG08910 coo G)Z 74 EXPIRES; APR 02, 2021 .- u) CX N01 = Revised 11/10016 �' q'�OF��`' Bonded through 1st State Insurance N� -4„< N V = cn .PERMIT # ISSUE DATE PLA.NNING & DEVELOPMENT SERVICES ` = Building & Code Compliance Division BUILDING PERMIT SUB -CONTRACTOR AGREEMENT G V1,u.IM,, uvw ti v� have agreed to be (Company Name/Individual Name the Q a.vw b i � Sub -contractor for (Type of Trade) tJ (Primary Contractor) For the project located at.h,�, (Project Street Address or Property Tax ID'#) 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. CPNTRACTOR SIGNATURE (Qualifiefi PRINT NA1V1E COUNTY CERTIFICATION NUMBER State of Florida, County of � Uk C The foregoing instrument was signed before me this �" day of 1�10L,1C ,2aZoby 3�hcl �On�Za who is personally known _Kor has produced a as identification. STAMP Signature of Notary Public Print Name of Notary Public BRIANNA GRAHAM 4P; ` MY COMMISSION#GG089105 il Nw EXPIRES: APR 02, 2021 Revised 11/16/2016 90',R Bonded through 1st State Insurance Ir SUB -CONTRACTOR SIGNATURE (Qualifier) r � PR]3 iT NAME F I- Jn LX COUNTY CERTIFICATION NUMBER State of Florida, County of " I e_ The foregoing instrument ryas signed before me this.2 day of GO - who is personally (mown Lor has produced a as identification. STAMP Signature of Notary Publi n n a, EDC ck-,Vl Print Name of Notary Public BRIANNA GRAHAM .10 MY COMMISSION #GG089105 EXPIRES: APR 02, 2021 ","` Bonded through 1st State Insurance n� aY PLANNING & DEVELOPMENT SERVICES Building &Code �: Compliance Division . . BUILDING PERMIT SUB -CONTRACTOR AGREEMENT J.A. TAYLOR ROOFING INC have agreed to be (Company Name/Individual Name) the ROOFING Sub -contractor for GROZA BUILDERS, INC. (Type of Trade) (Primary Contractor) For the project located at DUNN RD. -- 3403-702-0002-000.5 (Project Street Address or Property Tax 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. ^04 . ,., CO,ATRACTOR SIGNATURE( uatifier) SUB -CONTRACTOR SIGNATURE (Qualifier) Sohn AOAA oO vA G MZC` PRINT NAME COUNTY CERTIFICATION NUMBER State of Florida, County of The foregoing instrument was signed before me this v' day of Ott 0A 20 2J01 by T o h n 801-h 0' ro2,ct who Is personally known X or has produced a as identification. STAMP Signature of Notary Publ :hr\'Qnr-)0L GmL p-t- Print Name of Notary Public NAGRAHAM *SW SION #GG089105; APR 02, 2021Revised IIJ16/2016 gh 1st State Insurance KYLE WHITE PRINT NAME 23018 COUNTY CERTIFICATION NUMBER State of Florida, County of ST LUCIE The foregoing instrument was signed before me this I Oth day of MARCH , 2o20, by KYLE WHITE who is personally known XX or has produced a as identifica 'o Afo.. STAhTi Sig Notary Public NADINE MANRESA NA©INEMANRESA Print Name of Notary Public * *0OWssion#GG355203 w�, o� Expires November i 5, 2423 y OFF4oQ� Bonded ThniBudget NotarySendoas