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HomeMy WebLinkAboutSub-Contractor Agreement( 1 PERMIT # ISSUE DATE i PLANNING & DEVELOPMENT SERVICES Building & Code Compliance Division St. Lucie County Contractor Certifica State of Florida Certification pNumber /D®c06 16 am any aifie/Individual +pe of Tra e) For the project located at BUILDING PERMIT SUB -CONTRACTOR AGREEMENT Number: Sub -contractor for (Primary Contractor) or Prdperty Tax ID #) have agreed to be the It is understood that, if there is any change of status regarding our participation with the above mentioned project, I will immediately advise jthe 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 SIGN A RES ARE REQUIRED Business Name: .. �dOIS' ap U1,4 Address: City/State/Zip: /L(,GC.Ic31i %�S 3 Phone: % 2J,S 661 b email: S PRINT N E DAT STATE OF FLORIDA, COUNTY OF THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS DAY OF 20N BY 1 Jr4l.� . WHO IS PERSONALLY KNOWN OR HAS PRODUCED A ` AS IDENTIFICATION. (STAMP) Dt-- 1. B. J�U, 7 S AT F TAR LIC PRI T NAA9 OF IOTARY PUBLIC P!�r" SLCPDS: 12/16/2013 r ^� AUDREY 3. HUMPHREY '5 MY COMMISSION # EE 061159 la aQ€ EXPIRES: March 6, 2015 g�q:� Bonded Thru Notary Public Underwriters PLANNING & DEVELOPMENT SERVICES Building & Code Compliance Division BUILDING PERMIT SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification umber: State of Florida Certification Number (If apRlicable): 10629 COMFORT CONTROL SERVICES ER13014969 have agreed to be the (Company Name/Individual Name) ELECTRICAL I Sub -contractor for POOLS BY VITALI (Type of Trade) , For the project located at (Primary Contractor) McCARTY RD / 2333-234-0002-000-2 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, I will immediately advise the Building and Zoning Department of St. Lucie County by filing a Change of Sub -contractor notice. (Foirm: SLCCDV (No. 004-00) BUSINESS QUALIFIER (Na4ne of the Individual shown on the Contractor's License) NOTARIZED SIGNATURES ARE REQUIRED Business Name: Address: City/State/Zip: Phone: co.,nr,ay- Clo,JMoRU Icc:S. 1501 SW BILTMORE STREET PORT ST LUCIE, FL 34983 772-785-9010 email: LEAH.CCS@GMAIL.COM WAYNE ZIMMERMAN SIGNATURE LPRINT NAME DATE STATE OF FLORIDA, COUNTY OF ST. LUCIE THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS `� DAY OF ✓n b� , 20 ILA BY �lJ A�+,n�z+ ✓���''�I WHO IS PERSONALLY KNOWN X OR HAS PRO UCED AS IDENTIFICATION. (STAMP) C'�i!'IAT � TiTT T ATAT 1 Tom) TiTTi i!1 PRINT NAME F NOTARY PUBLIC SLCPDS: 08/06/2014 efh R M Notary PState of Florida � . Tracey ascola My Commission EE 193340 ovw° Expires 04/2612016