HomeMy WebLinkAboutSubcontractor Agreement '! I
_�; , . - PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
• Building and Code Regulations Division
IBM
BUILDING PERMIT
SUB-CONTRACTOR SUMMARY
Black Street Enterprises, LLC will be using the following sub-contractors for the
(Company/Individual Name)
project located at 8001 'Hamilton Avenue, Fort Pierce, FL 34951
(Street address or Property Tax ID#)
It is understood that if there is any change of status regarding the participation of any of the sub-contractors
listed below,I will immediately advise the Building and Zoning Department of St.Lucie County.
St.Lucie County/
Trade Name of Company/Contractor State of Florida
License Number
Electrical NA
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Plumbing NIA
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HVAC/ N/A
Mechanical
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Roofing Treasure Coast Roofing LLC 29843/CCC1330653
Gas N1A
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OFFICE USE ONLY
j PERMIT ISSUE DATE:
NUMBER:
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Revised 07/29/2014
PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Ir► u,. Building & Code Compliance Division
COUNTY
_.kP_ -_ BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
St.Lucie County Contractor Certification Number: 29843
State of Florida Certification Number(If applicable): CCC1330653
Treasure Coast Roofing LLC/Brian Maloney have agreed to be the
(Company Name/Individual Name)
Roofing Sub-contractor for Black Street Enterprises, LLC
(Type of Trade) (Primary Contractor)
For the project located at 8001 Hamilton Avenue, Fort Pierce, FL 34951
(Project Street Address or Property Tax ID#)
t is understood that, if there is any change of status regarding our participation with the above mentioned
project, I will immediately advise the Building and Zoning Department of St. Lucie County by filing a
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,Change of Sub-contractor notice. (Form: SLCCDV(No.004-00)
;BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License)
NOTARIZED SIGNATURES ARE REQUIRED
Business Name: Treasure Coast Roofing LLC
iAddress: 1816 SW Biltmore Street
City/State/Zip: Port Saint Lucie, FL 34984
Phone: 772-376-9770 email: tcroofingllc@gmail.com
Brian Maloney 01/25/2017
SIGNA144d PRINT NAME DATE
STATE OF FL COUNTY OF Saint Lucie
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS 25th DAY OF January ,20 17
BY Brian Maloney WHO IS PERSONALLY KNOWN X OR HAS
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PRODU AS IDENTIFICATION.
•
QV(9 Kristina E. Davis :�a :• KRRMM4)EDAWS
`: •': MY COMMISSION#FF960833
i S RE OF NOTARY PUBLIC PRINT NAME OF NOTARY PUBLIC
IGNT � EXPIRES March 08,2020
SLCPDS:08/06/2014
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