HomeMy WebLinkAboutSub-Contractor AgreementPERMIT*ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
1BU1 DWG PERMIT
SUXCONTRACTOR AGRIEEMMT
have agreed to be
(Co NaMrAndividual Name)
the me t!� el Q Sub -contractor for _
(Type of Trade) p
For the project located at
(project Street Addrep or Propc#Y Tax ID #)
It is understood that, if there is any change of statue egardiung our Participation with the above mentioned
project, the Badiag and Code Regulation Division of st. Lucie County will be advised pursuant to the
{ling of a Change of Sub-Contiaotornotice.
CON TRACfoR 51GINATURE to 0111100
VMS NAME
COUNTY ClUFM—CATION NUMBER
State of FWda, County of J,
T regolag lnWOM:nt WEN ■ A¢ heto me tbts,; day os
/�-, .sn
who.ia,p�►��814' Imo�n or K ptrodalz�d a
41Ie1atlt y BURP.
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r'• /' tsrArfr
wee1.,-n.d'Nol.pw Puh11�
Print Kum of NolAri Public
o��rruB�,
a �•••�' o
SHERRI FEHLMAN
Commission # GG 187160
�e
Expire® March 14, 2022
RevlEedll1751f016 'oFFV
6MOMTtuugudjotNotary Somm
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COUNTY CE6 CS ER
6tatc et"'FlorldA. County
ffImplaglattrunwntwas alp �b7Z61A/ v ti
Frlut ame of Nptury PabUc
SHERRI "''• FEHLMAN
Comrnlsslon # Gg 187160,
��` or Ffrot�Q Band9tl 1TTuu �e Nblfarl'Servfoes
PERMIT # ISSUE DATE
W
Wlbs.
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
�QLl,QE til �DO �,S
(C m ny Name/Individual Name)
the / �ja 1�Gj Sub -contractor for
(Type of Trade)
For the project located at
2F
have agreed to be
(Primary Contractor)
(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.
ONTRACTOIt SIGNATURE (Qualifier)
;�eeo'8 . �' A /� ti110
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County bxr/
-he foregoing instrument wa d before me thil day of
v
who is personally known or has produced a
as identification.
iL STAMP
[� ignature of No ry Public
Print Name of Notary Public
SHERRI FEHLMAN
Commission # GG 187160
��1 `o� Expires March 14, 2022
Revised I I/16/2016
�0'PT9 e01dodTh-8W9etNotaryswjces
Al , /,/- -�A_ - - '/'_
SUB -CONY CTQSR SIGNATUR quali ier)
PRINT NAME
�-7 J
COUNTY CERTIFICATION NUMBE
State of Florida, County of
T,Woregoing instrument was signed b fore me this,, day of
2o2/by .�
who is personally knownL—Z--%r has produced a
as i nti i ation.
STAMP
_Sl nature of Notary Publ
Print Name of Notary Public
�b�k�i:Pllpa
SHERRI FEHL
w Cornmisslon # GG 1871
60
yF f k Explres March 1420
c��22
rtn awamNof ;
PLANNING & DEVELOPMENT SERVICES DIVISION
BUILDING & CODE REGULATIONS DIVISION
2300 Virginia Ave
Fort Pierce, FL 34982
BUILDING PERMIT
SUB-C NTRACTOR SUMMARY
�LQL�y— will be using the following sub -contractors for the
(Company/Individual Name)(
project located at
'zD
(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.
Trade
Name of Company%Contractor
St. Lucie County/
State of Florida
License Number
Electrical%
r
n
Plumbing
HVAC/
Mechanical
Roofing
Gas
OFFICES>i7SEONTJxY
PERMIT ISSUE DATE:
NUMBER: