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Home My WebLink Aboutsub contractor agreement ALL APPLICABLE INFO MUST.BE COMPLETED FOR APPLICATION TO BE ACCEPTED (�1 Date: Permit Number: Building Permit Application Planning and Development Services rj ht,i i TING Building and Code L Lud#e.Coun Regulation Division tY,FL 1 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X PERMIT APPLICATION FOR: Building PROPOSED IMPROVEMENT LOCATION: Address: 5 LA VILLA WAY Legal Description: EAST 1/2 OF SECTION 1 -TOWNSHIP 34S-RANGE 39E PropertyTax ID#: 1301-111-0001-000-5 Lot No.5 Site Plan Name: COUNTRY CLUB VILLAGE Block No. Project Name: Setbacks Front 29' Back: 25' Right Side: 22' Left Side: 27'6" [DETAILED DESCRIPTION OF WORK: SINGLE FAMILY RESIDENCE (replacement home) - 2 BEDROOM - 2 BATH - GARAGE i CONSTRUCTION INFORMATION: Additional work to be nerformed under this permit—cleck all apply: ZHVAC _Gas Tank Gas Piping Shutters Q Windows/Doors ❑✓—Electric ❑✓_Plumbing Sprinklers Generator W1 Roof Total Sq. Ft of Construction: 2,108 V S . Ft.of First Floor: 2,108 L� Cost of Construction:$ 58,000 Utilities: Sewer Septic Building Height: OWNERAESSEE: CONTRACTOR: Name WYNNE BUILDING DEPARTMENT Name: MATTHEW LYLE WYNNE Address:8000 SOUTH US HWY. 1 -SUITE 402 Company: WYNNE DEVELOPMENT CORPORATION City: PORT ST. LUCIE State:FL Address: 8000 SOUTH US HWY. 1 -SUITE 402 Zip Code: 34952 Fax:(772)878-76M City: PORT ST. LUCIE State:FL Phone No.(772)878-5513 Zip Code: 34952 Fax: (772)878-7656 E-Mail: Phone No. (772)878-5513. Fill in fee simple Title Holder on next page(if different E-Mail: from the Owner listed above) State or County License: 08898 j If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. I PERMIT# —" ISSUE DATE PLANNING & DEVELOPMENT SERVICES Building & Code Compliance Division s e BUILDING PERMIT SUB-CONTRACTOR AGREEMENT I ec.. ( r c X-A e- have agreed to be (Co pally Name/individual Name) the (le c-T,-,z e. / Sub-contractor for �=i,�,� � /��i� f u�� r'.�%�c•�/� FoJ (Type of Trade) (Primary Contractor) the project located at �a\��G G (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. CONTRACTOR SIGNATURE(Qualifier) 4WCONTRACTOR SIGNAT (Qualifier) PRINT NAME PRINT NAME COUNTY CERTIFICATIONNUMBER COUNTY CERTIFICATION NUMB B"ER Stale of Florida,County of w �1 State of Florida,County of 6A • Li-e. Thi foregoing instrument was signed before me this ay of The foregoing instrument was signed before me this day of zo\l byqAc ' ,� 20\3 by 1aV314ty cp IJNII is personally known or has produced a who is personally known _or has produced a as identification. as identification. STAMP STAMP Signature of Notary Public *Snt."rofNotary Public Print Name of Notary Public Print Name or Notary Public . t r Nolaty Publlc State of;Florida ?�.x��;' ; ,UU LA RA A.R.R. SOEDGE �' kerti BudKa 978543 , Commissiom#GG 0220T6 ItMy Corom168M FF Revised 111162016 oA Expires 0512512020 ��oatq?'goTroyFainUqur�rtrsrltiD�5Tp19 oFftip �qpm i ..I PERMIT# ISSUE DATE PLANNING & DEVELOPMENT SERVICES ' ' `� = - Building & Code Compliance Division BUILDING PERMIT . SUB-CONTRACTOR AGREEMENT a Y ry I C,E S c, have agreed to be theoompany Name/Individual Name) lumbi ;-ic, ub-contractor for'Loqrin Q, �{Y Q- ,o m e- TT C,a R p (Type of Trade) \ \' (PrimAry Contractor) or 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 filing of.a Change of Sub-contractor notice. CONTRACTOR SIGNATURE(Qualifier) SUB CTOR SIGNATURE(Qualifier) l I 1 IOC QME tt AA 'PRD&r NAME PRINT o ssa -8 -0aE COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NU 1MBER Spate of Florida,County of 91-- Gt State of Florida,County of SZ•U-1 ca P—, The foregoing instrument was signed before me this da of The foregoing instrument was si d before me this da of g g g Y g g � Y 2& 1,by who is personally known or has produced a who is personally known or has produced a ai identification. as identification. (.mil YIJC}YfMn 6 STAMP STAMP Signature of Not Public 2S.glry Publi ®.tQ frly A/yo -6.4SKtry c C. print Name of Notary Public Prhit Name of Notary Public DOROTHYANN BASKIN ter'..'. .. _ . .•._.x; :.'''.'._ .`!;.wr": _ T-. `�w, MY COMMISSION#GG 030145 ?� EXPIRES:October2,2020 ,os ,r"'ems- ��ONDA LAFFERTY °t Bonded Thru Notary Public Underwriters r :': MY GOMMISSIOIV#EE854297 �' ': ?• EXPIRES January 08,2017 r Rev 09�rr,• ,, f (407)3c18.0153 FloridallotaryServica.com Y PERMIT* ISSUE DATE n A ANC t` &DOW191 oP M-9 Nw SIKK'VICES ,; u ticlit ag&C6&Com pl%anlce Division B1�iD1�11'G?PEa�tM�I'. • . . Sty-COI TRA OR AGREEMENT . Comfort Ct►.rttrol of S.t.. 'Lucie County, lim. haveagxeed'to'be (Company NhmeAnfiividua,L Name) the HVAC Sub-obrikietorfbr Wynne Development 'Cori). (T"e,Of Trade) (Primary►contractor) . For the project Ideated at �� 4` '(Project Street A;dams'or?fopeM Tax ID 0) Ti is 1dndersto6d:tha4 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-coiitractor-notice. CQNi"CTOR S1WAnW(QiiaNC1r). IGNATURE(Q�ui9lifier) Ka:zt•hew Ll.e Wynne Bar: .: .. . erman PRINT NAAM' IPRINT NA;1►:tE COUNTY CERTIFICATION NUI M A COUN Y CEIRTWrAnON NUMBER tatate afFiorida,Coattty df S i, c F . State of Flarids:County of Si eci The foregoing instrument was siehct!before me this ay of ( The foregoing instrument was slued befotre me this Y'day of 104 by� "`� � �u� :1G 20�by?—� Z 14A*hy e MAQV( who is personalty.known✓OY has produced a who is personalty known�r has produCed.A al fdenttficaliem as identification. I STAIVYQ• 15gu'stoieofNotary 'c -or Way c STAIVffi :t; o::r2:.oM)1�: niy �RSKra a. o` l.`/ HNN 419Skl.y piilutl�Taale oftYotaryPubtic Print Name:of Notary Public •,;kYcc,,• DOROTHYANN BASKIN � ••. •, DOROTHYANN BASKIN ¢* •+: MY COMMISSION#GG 030145 •.•�R•• .� s' ��;' EXPIRES;October 2,.2020. _r,: ;+ . MY COMMISSION#GG 030i45 Bonded ThN:Notary.PubleelJndeiwriters °; o;, EXPIRES:October 2 2t110 � O Nco' 9nnded Mnj:No Rg*sd 11/16/2016 -�•,�,��.,�''• tary Rfturwe*jt(, L66-d ZO00/3000d VLO-i 999L8L83LL da00 Suipjino auuAM -WO�A 9L=ZL 96r 60-3L PERMIT'# CSStJ�cl7p l`I=': PL ON AN N Did Witg �o.��+Ca;<ng�i;I�nee I3 his oa Trasre' G .a::st lQ`sf'311:g:: : .iaveaetab I � s?mpar�y;I�amellitdiuidt ANN. me):: �:of:T'a°ate I#is u atiexsCt�od� ift iete'.i ariy°ei r ge:o Statti�s�egarc g cur part ii pa iOi w3 i:tote pr�sje :te Budding a>3ioci . gulaiiol3��izoi of t�cie Con :wit1 :ays�e .ptarsea�i `fi . : .14 .-Mal otITTY c>E�xr> ca rzoi`r nzum�a cctnvxeAarrtavix' T u cS ;;iatgof.FMriila;�onq�y�o1{� C ,.,.: Sta'teof"Flotaila��otiritji`of� GEC li'efarego.Inglin5irameni:etas:signe :tieifuremg.t6is . ..:"�ayoF.• '!(lieturcgoiri ;aitstlruirieritiv�s's%ggliiksForeme':tffi5I 'dsiyof. C" o :hy �� wlo:upccsona)Iyiirto..wn✓grh�s:pmtacCda:.: :..;i who"u.pergaingu' IRA., aduceda` �47 ideuli�icaUg�: �s�ident�e2tioh: ` ►.:. :.. . ... � 1 . . .. o sT a�iforc:A�>�fo� .PptiliN � `5ignahi�2e-�ffilut'a►�!' ritilis;. SLJ.o::YLO�i'k1.� .j�-nrr� dJA-S1�r:r� . ��:2 o—n.t�/. ../-i�NN /JA•SKi� "rit:NAn*dfN4tai v:P-u Rriiit.i►.`aritie:of:i�ipfa y l?n�sii e DOROTHYANN BASKIN MY COMMISSION#GG 030145 �,zoS '%:8��.,: DOROTHYANN BASKIN EXPIRES:October 2,2020 ., MY COMMISSION#GG 030145 r.... Pr '4r, �o;= 020 .Bonded Thrti Notary_PublicUndenvriters EXPIRES:. ...o,,. Bonced 7hm Note ryRublicaJndenvriters I