HomeMy WebLinkAboutSub Contractor Summary with back up 3.17.2021r PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
• Building and Code Regulations Division
BUILDING PERMIT
SUB -CONTRACTOR SUMMARY
will be using the following sub -contractors for the
(Company/Individual Name)
project located at
8228 S Ocean Drive
(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
CarneyEletrical
EC13012944
Plumbing
-•
V 6
HVAC/ l
C M 1
18614
Mechanical
Roofing
Micheal Kevin Walsh Roofing
28578
Gas
Como Gas
05594
27064
OFFICE USE ONLY:
PERMIT ISSUE DATE:
NUMBER:
Revised 07/29/2014
PMP
COUNTY
F
L
U R
l V R
the
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Xmpany Ndme/Indlvidual Name)
AQ�.'�1LlT.l(�'!� Sub -contractor for
(Type of Trade) '
P
For the project located at S
(Project Street Address or
Tax ID #)
Contractor)
have agreed to
L
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)
A1ft 't) k
P1kINT NAME
3g
COUNTY CERTIFICATION NUMBE
State of Florida, County of
The foregoing instrument was signed before me this day of
t$ && 29�►'t , by X*)
who is personally known or has produced a
identification.
STAMP
Signature of Notary ublic
Print Name.oLNatamRu iL — — _ _ _ — — _ _—
�QA. � Notary Public State of Florida
Frances Donza
,per My Commission GG 092440
Apo' Expires07/27/2021
Revised 11/16/2016
State of Florida, County o
The foregoing instrument was sig ed before me this I 1 day of
, 201 by �t�
who is personally known \ or has produced a
as identification. �{J
STAMP
Signature of Notary Public
(--f- A�Le S T
Print Name of Notary Public
g40 N Notary Public State of Florida
Frances Donza
My Commission GG 092440
?awd' Expires0712712021
PERMIT# ISSUE DATE
COUNTY
F L O R I D A
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
(Company Name/Individuil Name) ' I
the 12 \ ; C(� Sub -contractor for
(Type of Trade) ( (Primary Contractor)
For the project located at
Im
(Project Street Address or Property Tax ID #)
RECEIVED
APR 202011
BY:........
have agreed to be
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.
NTRACPOR SIGNATURE (Qual' ier)
PRINT 14AME
COUNTY CERTIFICATION_��V/�UcerC
State of Florida, County of
T foregoing instrument was signed before me t is day of
2Q�[, by
w o is personally known \, or has produced a
as identification.
STAMP
Signature of Notary -Public
Print Name of Notary Public
OW
Notary Public State of Florida
a4
Frances Donza
My Commission GG 092440
0
;it OF f`,d
Expires 0712712021
Revised 11/16/20
SUB-001W1aCTOR SIGNATURE (Qualifier)
Ln c, l dl i_l L14C
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of `W n
The foregoing instrument was signed before me thisn day of
r t 1 , 20 I-1, by ! 2Yea t 4 A\\:- .7t
who is personally known 'Lor has produced a
as identification
STAMP
Sig ure of Notary Public '
Print Name of Notary Public
LAURIEURY
MY COMMISSION 4 FF 210664
•.o,= EXPIRES'. July 15, 2019
•.; �F �;,c Bonded 7hN t`:otary Public Undeiwn ers
PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
'COUNTY
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
—� T omp y Name/IndividuaName)
the
(Type of Trade)
For the project located at
Sub -contractor for
(Project Street Address or
Tax
have agreed to be
(Primary Contractor)
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.
A-,/,
CONTRACTOR SIGNATURE (Qualifie
PRINT NAME
COUNTY CERTIFICATION N ' B :R
State of Florida, County of rL
The regoing instrument was signed bef a me this day o
20 Z by AK/
who is p sonally known _or h p oduced a
aeration.
STAMP
Si ature of Notary Pub c
Print Name of Notary Public
R
Notary Public State of Florida
Frances DonzaMy Commission GG 092440
Expires07/27/202?
Revised 11 162016
1�
SUB-CONT CTO SIGNATURE (Qualifier)
PRINT NAME
L 7
COUNTY C RTIFICATION NUMBER
State of Florida, County of 4m
The foregoing instrument was signed before m t�his� 42 of
20Qi�A
, YtC .
who ' sonady known for has produced a
aside tificat' on.
STAMP
Signature of Notary Public
Print Name of Notan Public
R
EK
of Florida
065254
PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
For the project located at
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.
NTRACTOR SIGN U IRE (Qualifier)
PRINT NAME
0 A -1
COUNTY CERTIFICATION NUMBER
State of Florida, County of
The foregoing instrument was signed before me this _ day of
20 , by
who is personally known _or has produced a
as identification.
Signature of Notary Public
Print Name of Notary Public
State of Flora
lic Sta
tJotary PS a 092440
oyp FranceJls,moo Go
Rev' e� 6 Expres 0712712021
& ONT CT, R SIGNATURE (Qualifier)
f
PRINT NAME
/ OUN� CERTIFICATION NUMBER
State of Florida, County of
The foregoing instrument was signed before me this day of
20_, by
who is personally known _or has produced a
as identification.
STAMP STAMP
Signature of Notary Public
Print Name of Notary Public
a
llotary Public State of Florida
Frances Donza My Commission GG 092440
% Expires 07/27/2021
PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
v -E - Building & Code Compliance Division
•
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT �J
St. Lucie County Contractor Certification Number: ;� 7�-o 6 4 l d
6
State of Florida Certification Number (If applicable): shim l AtEN$E '#OSS 4
(Company Name/Individual Name)
4-P - GA, % Sub -contractor for
(Type of Trade)
For the project located at
(Primary Contractor)
(Project Street Address or Property Tax ID #)
have a eed to be the
�a ZZI-1
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)
BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License)
NOTARIZED SIGNATURES ARE REQUIRED
Business Name:
Address:
City/State/Zip:
Phone:
172 -..2 q �1 - 19 OQ email: �C �T% L"pxo FjoR �/� • �OI"`
XT /5
C#k.L is
SIGN RE PRINT NAME DATE
STATE OF FLORIDA, COUNTY OF 6 NCO � L_
THE FOREGOIN?�NSTRUMENT WAS SIGNED BEFORE ME THIS tj DAY OF 4 , 2z
B
PRODUCED
WHO IS PERSONALLY KNOWN OR HAS
AS IDENTIFICATION.
I
SIG ATURE OF NO RY PUBLIC PRINT NAME
SLCPDS: 08/06/2014
�
u lic State of Florida I'rances Donza
v My Commission GG 092440
?l r rto� Expires 07/27/2021
(STAMP)