HomeMy WebLinkAboutSubcontractor Agreement I
PERMIT# ISSUE DATE
(PLANNING & DEVELOPMENT SERVICES ,. , !E V 'I ;
° - 4 Building & Code Compliance Division
NOV 0 9 2017
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
PERVI11
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St. i_ucie
St.Lucie County Contractor Certification Number:
State of Florida Certification Number(ifapplicabte):
have agreed to be the
Company Name/Individual Name)
C)e L< ti, ( Sub-contractor for
(Type of Trade) (Primary Contractor)
{ c,
For the project Located at ���'`;�-- � Lti� ��1 �\ '�0�,� r����-,� ' L � ,�A �
(Project Street Address or Proper Tax ID#)
It 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
Change of Sub-contractor notice. (Form: SLCCDV(No.004-00)
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BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License)
NOTARIZED SIGNATURE,S ARE ARE QUIRED
Business Name: csAc, B 0 �(��
Address: ��1� �—� ti�\��: c 0 t.
City/State/Zip:
Phone- ��;-�-7'•`�'�(�— q 1A email: is iC'c i '
SIGNATU PRINT NAME DATE
STATE OF FLORIDA,COUNTY OF 1 LU 0_,� E
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS PAY-OF
BY - A�jt�l O IS PERSONALLY KNOWN OR HAS
PR D1 D I AS IDENTIFICATION.
u
(STAMP)(
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SIGNATURE OF NOTARY PUBLIC PRINT NAME OF NOTARY PUBLIC
SLCPDS: 08/06/2014
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NOV 0 9 2017
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PERMIT# s ISSUE DATE
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PLANNING DE+VEl ILOPYIENT SERVICES
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Its�� � ���� �'•�
1 tr 4L i to BUnDING PFPdVff1
SUB-CONTRACTOR AGREEMENT
have agreed to be
ompany Namelndividual Name)
the t U Sub-contractor for
(Type of Trade) (Primary Contractor)
�i
For the project located at.� 1 , �• �_��l C. �-�. � �.�: � �
(Projec`t Street Address or Property Taz 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.
Lr�
CONTRACTOR SiGNA-TURE(Qualifier) UB-CONY ORS A URE(Qualifier)
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PMNT NAME PRINT NAME
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COUNTY E TIMCATION NUMBER COUNTY CERTIFICATION NUMBER
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State of Florida,County of_,�lL State of Florida,County of Sk lxt�^�
The foregoing instrument was signedd before melt�his day of The foregoing instrument was signed before me this {O�day of
N1V�lSld! zoL,by J� � -1i.i'�7s� ( 20 i l by �i1Jk r$ `_a:Jdl�w—
who is personally lmownVor has produced a who is personally known_?L or has produced a
as id ntifi lion
as identification.
a STAMP C STAi17P
Sign atm of k otary Public Signature of Notary P 1 c
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RHONDA L AFFERTY
Print ame of Nota Print Name of Notary P1611
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PERMIT# i J-4C O 1— ISSUE DATE
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P1LANNI[NG& DEVELOPMENT SERVICES
Building & Code Compliance Division 7�
BUILDING PERMIT �
SUB-CONTRACTOR AGREEMENT
NOV 0 9 2017
�Ee;v�I�7r;•;^
St. Lucie Co (:• EL
1.
have agreed to be
(Company NametIndividusl Name)
the 1 l
( Sub-contractor for
(Type of Trade) (Primary Contractor)
For the project located at- 00—I —ca N(A \�-N f D.
'Project Street Address or Propern Tax ID#) '
�y S - k-c LJ .- CC.5� C �
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) UB-CO\t' . Cr•R SIGNATURE(Qualifier)
PRIN'r NAME PRINT NA1
C Act)
COUNTY CERTIFICATION NUMBER COUNT]}CERTIFICATION NUMBER
State of Florida,County of ��.i_l±.l t= State of Florida,County of l
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The Foregoing instrument was signed before me this c dar of The foregoing instrument was signed et m.tins i� K � d t before e � dal),of t
� :r r-i o
�• 7 ,zo� 1,by�rj'�,G� kC L:,ll i.i Of ,by ";=�.✓r .n�.� l (��
who is p aonally Imoten V or has produced u tvlm is pens gli,1�;olvrt_or,has produced a
m identi atio as idep tcation.' �l n
--I--ST
Signature of Notary Public Signatnre of Notary Pul c
AMP
4I �:�
Print Name of Print Name of Now)-Public
Y .,pr".ere•., SHERRI KELLEY 99G2i(i
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PERMIT# _ ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
i
Building & Code Compliance Division
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT NOV
on
2017'
'PEPMI TItdG
St. Lucie County, FL
I
Kamrell Windows and Doors have agreed to be
(Company Name/individual Name)
the Windows Sub-contractor for Rubin Custom Homes
(Type of Trade) (Primary Contractor)
i
For the project located at 2007 NW Laurel.Oak,-Palm City, FL 34990
(Project.Stree£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.
CO CTOR SIGNATURE(Qualifier) ;BZ-CONT;R�ACTORSIGNATU (Qualifier)
PRINT NAME PRINT NAME I
C' C
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER
State of Florida,County of ,.U_ State of Bloridu,County of r+
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7:��m..t was signed before me this 'Qday Iof The foregoing instrument was signed before me-this eA day of
20_�,bbyy �I f V( 0-611J '20 by l�G M tiff(`C�1 J S!Z
wiio is personally known or has produced a who is personally known___or has produced a
as identi i do , as identiFica' n.
STAMPiP
Signatu ~P{otary Pnblic are of Notary Public
Print Name of Notary Public Print Name of Notary Public
SFIERRI KELO
PATRICIA A.KELVASA
;_?'r '1 Commission#FF 999218 :°l '�o MY COMMISSION 7#FF085476
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