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Home My WebLink AboutSubcontractor Agreement PERMIT# ��l `^ ISSUE DATE - - PLANNING & DEVELOPMENT SER _�GENE y Building& Code Compliance IDiv' y BUILDING PERMIT , OCT 0 6 2017 SUB-CONTRACMR AGREEMENT �a BY: y", J j�� ` 6 I a .� Dave agreed to W, (Company NameAndividual Name) the Sub-contractorfor (Type of Trade) `� / (Primary Contractor) / / For the project located at �a d2�A G--,iA,5- �� (Project Street Address or Property Tax ID#) ,Zya7 - 7dl- oocla 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 ; fling of ange of Sub-contractor notice, Nit( -__ SUJ�-CONTRACTOR SIGNATURE(Qualifier) PRwr NAW PRINTNAA4E COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER State offlo_rida,Countyof State Of Florida,County of The lbregoing instrument was signed Before me this/)� 'dayy of The foregoing instrument�was signed � be�foree a this day of 20a by / who is personally(mown has produced who is personally i-nown or has produeed a a Iden ecaliotr. as identification. r, (�eaSTAMP 00S_TAMP S12gnatme of N046 he SignatureNotary Public Li&bA 3,eM AT W Print-NameolNotacyP_ublie itgaultdo -_ -- CYNTHIA J DAY A1IR6NCmuo �' :°- Notary Public-State of Florida (1f1� �lYIMtIUIt�liiFF090961 ° °Q Commission#FF 976346 WMMAp Q2L2018 "%�°� o�o�� My Comm.Expires Jul 9,2020 �'��oni�a• �t Revised 11/16/1016 `� PERMIT# 11701-0391 ISSUE DATE 1/20/2017 -- ------ ---- - PLANNING & DEVELOPMENT SERVICES Building & Code Compliance Division a _.--__-.__ ---------_-�--. BUILDING PERMIT SUB-CONTRACTOR AGREEMENT Local Guy Air Conditioning INC have agreed to be l�y (Company Name/Individual Name) � � !�C &KO14 the Mechanical-HVAC Sub-contractor for (Type of Trade) Contractor) For the project located at 805 N. Lake Drive unit C Fort Pierce Florida (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 f a hange of Sub-contractor notice. CONTRAC (Qualifier) SUB-CONTRACTOR SIGNATURE(Qualifier) k, arc L � PRINT NAME PRINT NAME a�170 (Lo Y1 COUNTY CERTIFICATION NU�M�BE�R/1/� COUNTY CERTIFICATION NUMBER IERR State of Florida,County ofs/,% "7 C/ State of Florida,County of l/1 Y l The foregoing instrument(was signed beforemethis3oAay of The foregoing inst.amcut was signedbeforeme th`iss day of�J� ,201 b byey�l/I cel C-J, S 20Aby� )\ TI.L�^ who is personally known V or has produced a who is personally known or has produced a Zof n, nas iddentification. Q _.....___ STAMP W) t lO STAMP o Public Signature of Notary blic LlN A)Cguo &Sh1-et e k ra r Q Print Name of Notary Public Print Name of Notary Public LINDA BRONCATELLO MYCOMMISSION#GGI93980 :�,h�"! ASHLEE M BELTRANENA EXPIRES:April 21,2022 °` c MY COMMISSION#'FF902180 r, EXPIRES July 22,2019 Revised 11/16/2016 1407)31 ,0lb9 FloidaryomrySorwcexom.. PLANNING&DEVELOPMENT SERVICES ` - - BUILDING& ZONING DIVISION 2300 VIRGINIA AVE FORT PIERCE,FL 34982 (772) 462-1553 FAX 462-1578 CHANGE OF CONTRACTOR,SUBCONTRACTOR OR CANCELLATION OF PERMT PLEASE SELECT ONE OF THE FOLLOWING: CHANGE OF CONTRACTOR-Change of Contractor is to be signed and notarized by the property owner, and the new contractor of record for the current permit.A new permit application must also be completed with new contractor information and signature. A new Notice of Commencement must be filed in the new contractor's name for job values greater than $2,500 ($7,500 if A/C Change-out). A recorded copy must be submitted prior to commencing any work.There is a$50.00 fee for the Change of Contractor. CHANGE OF SUBCONTRACTOR-Subcontractor changes are to be completed by the general contractor. The new subcontractor must fill out a Subcontractor Agreement Form.There is a$50.00 fee for the Change of Sub- Contractor. CANCELLATION OF PERMIT-The cancellation of a permit is acceptable only if no work has beedone. Cancellation of permit is to be signed and notarized by both the owner and qualifier of record. There is no ee for cancellation o- 6 f-the permit. Date: -7—OL) `, Permit Number: /70/ — 03V_ ` Site Address: C !�Z� A4 77-1 Z-� P1�i P - State License SLC License Original GC,subconftactprpr owner/buil der !(//�`� eooc-LL State Licens (-)9 7(0 C1 SLC License New GC,Subcontractor Reason for Cancellation (00 f 0- The undersigned does hereby agree to indemnify and hold harmless-St Lucie County,its officers,agents and employees from all costs,fees or damages arising from any and all claims of action for any son wh' ar as a result of this change of contractor/subcontractor or cancellation of permit.A permit canno e d if work has b en performed. /'ZWZ r.,4 0, ) t SIG14ATURE OF O or wn-Auilder) SI NA � /�CO CTOR(ornew CYC,as applicable) PRINT NAME C-VA c rS C a PRINTN State of Florida,County of St.Lucie County State of Florida,County of St.Lucie County ' 3�d:y loingins ent was I, ,dg before me this l owing m t ac edg fore me this of b =y of 20by y lino me -QS � who;s personally known to or who has roduced as ID. me or- has produced as ID. OJJI� S�3t &nAA1 }- f 3� Signature of N Date J) Si oULUYto the AIWA Q, AS LEE M®ELrRANENq Revised 04 1' :'fNY CnMfNIS$ION Fpg02780 A�yP��c LINDA BRONCATELLO EXS�I✓lES July 22,2019MY COMMISSION#GG 193980 woad EXPIRES:April 21,2022 C1- PERMIT# 1"701 / / ISSUE DATE AN PLANNING & DEVELOPMENT SERVICES Building & Code Compliance Division 9 BUILDING PERMIT SUB-CONTRACTOR AGREEMENT << I _ CD . 1�� have agreed to be (Company Name/Individual Nam the t yy4c .., Sub-contractor for it, "J (Type of Trade) (Primary Contractor) �! For the project located at 50§_ Al� . A/f (Project Street Address or Property Tax ID#) t9la7 '71l 0011 ' 600 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 oft Change of Sub-contr, ctor notice. C �IiTRA O ATURE(Qualifier) l Su RACTOR SIGNATURE(Qualifier) PRINT NAME• PRINT NAME C&C066 ? 3acv S -) 123 COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER. State of Florida,County of '_ State of Florida,County of The foregoing instrument was signed before me this-9) day of The foregoing instrument was signed before me this-4—day of 20 pl:),by C Pt"S - ,20 ;by kA� wax who is personally known_or has pro led a T;L who is personally known_or has produced a as identification. a�-ide7ntificatio STAMP STAMP Signature of Notary Public ' Signatufle of Igotary Pu 'c / 1ndaArm, Oklk_ Print Name of Notary Public Print Name of Notary Public e = = LINDA BRONCATELLO r: (WY C®Miwll§ l@ FF206436 MyCowMSSION*FFOMI EXPIREM N1601 93;2019 7S'� �iRES>Npn721,2018 a;•, '��-C'S'; FIOFlt1iiN;ltA°'i?kr,:jcc ccir at Revised "-- --