HomeMy WebLinkAboutSubcontractor AgreementPERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to be
(Company Name/lndividual Name)
the _e (e (-b6 Coil Sub -contractor for L (NW20 MA R I W E
(Type of Trade) (Primary Contractor)
For the project located at [ ,-� - 1
(Prof ect
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.
CON' SIGNATURE (Qualifier)
A 1A A CC -e -F-it7
COUNTY CERTIFICATION NUMBER
State of Florida, County of {. U/tr : L
The foregoing instrument was signed before me this day of
20Lby )MAVVlCe- -C4Z
who is personally known Xor has produced a
STAMP
0Y �� JAMIE PUGH
r�% ' �o MY COMMISSION #GG047204
EXPIRES: NOV 14, 2020
Bonded through 1st State Insurance
Revised 11/16/2016
_x
SUB -CONTRACTOR SIGNATURE (Qualifier)
e. • .
hevr/ k, Al l de r
COUNTY CERTIFICATION NUMBER
State of Florida, County of �ln_,
The foregoing instrument was signed before me this day of
U , 20L, by /.i IA Y I C
F-6w 2f�
who is personally /known Kor has produced a
as identificati
STAMP
Sign re of N ry Public
w
Print Name of Notary Public
�
c`
JAMIE PUGH
ox;
MY COMMISSION #GG0477EXPIRES: NOV 14,2021 mBonded through 1st State Insu- y N n
Z y
^ pprn
� N A
c�a A m
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
Building and Code Regulations Division
BUILDING PERMIT
SUB -CONTRACTOR SUMMARY
utj o yN l�r� Lt$h Q 1Y ,JIJAL will be using the following sub -contractors for the
(Company/Individual Name)
project located at
(Street address or Property Tag 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.
Trade
Name of Company/Contractor
St. Lucie County/
State of Florida
License Number
Electrical
` s- �r SP✓
w r e
Plumbing
HVAC/
Mechanical
Roofing
Gas
OFFICE USE ONLY:
PERMIT ISSUE DATE:
NUMBER:
Revised 07/29/2014