HomeMy WebLinkAboutSubcontractor Agreement PERMIT# ISSUE DATE
-- PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
�
9. 6
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT MAY O 3 20W
PEfiRti1T`;;
St. Lucie i::c•.
C00/l/ s v� �- � "
C 'f_ have agreed to be
(Company Name/Individual Name) /-'
the /��/,�G Sub-contractor for Z-0/c,
(Type of Trade) / /�/ (Primary Contractor)
For the project located at�'G 7L `�'"
(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.
CONT CTOR SIGNATURE(Qua' er) CO CTOR SIGNATURE(Qualifier)
boo,* A
PRINT NAME P NAME
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION N�UMBE�R�State of Florida,County of—L� State of Florida,County of v -i' e_
The for oineg i/n�strumenyyt was signed before mee+thig ' day
//of The foregoing instrument was signed before me this day of
r ! ,z0/ by Sc�fT 4r, , 20 f,by 71 0_ffV!t?S c5/1 CVd1
who is persoually.known_or has produced a who is personally known or has produced a
as identification. dentification.
STAMP
Signature o Votary P lic Signature of Notary PublicSpgRIN,q svP
SA,BRIiVf� L. 131rACK ••�oti lssi0•�'.�9�;'
Print Name of Notary Py lic Print Name of Notary Public a rD 5
:.. III`!8t �nI�T YS
Notary Public,State of Florida 9�;�y�o 953�
i o dihN 'P s
r Commission#i FF 17588 :%��Ge!///� d �•Q`0���
rl MAy Comm.expires July 17,2017 y�iflc s1ATE OF ��`��
Revised 11/16f1016. �1i1111111���
PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
-1' Building & Code Compliance Division 14`�
BUILDING PERMIT MAY 3 0�
SUB-CONTRACTOR AGREEMENT
St. Lucie C;::i:i,. : 'E
J.A. TAYLOR ROOFING INC have agreed to be
(Company Name/Individual Name)
the ROOFING Sub-contractor for L & C CONSTRUCTION
(Type of Trade) (Primary Contractor)
For the project located at 387 NETTLES RI VD, JENSEN BEACH
(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.
COf RACTOR SIGNATURE(Qualifier) y� SUB-CONTRACTO SIGNATURE(Qualifier)
Z ,r'/l e k1 � LO L n--I r2— KYLE WHITE
PRINT NAME PRINT NAME
23018
COUNTY CERTIFICATION NUMBER" COUNTY CERTIFICATION NUMBER
State of Florida,County of /�/ A 77 y�, State of Florida,County of ST LUCIE
The foregoing instrument was signed before me thi-/i of The foregoing instrument was signed before me this 26thday of
E_ ,2017,by APRIL ,2017,by KYLE WHITE
who is personally known_or has produced a who is personally known XX or has produced a
as identification. as identifi atiun.
STAMP
��� STAMP
Signature of otary Pub Signature of Notary Public ��ii:ilillt/i!
t
NADINE MANRESAy(pnw-Foh'
Print Name of Notary Publilf Print Name of Notary Public
KATHY K.GATES Ln
Notary Pudic,State of Florida -
r Commission#FF 17588 Yr 53oL'c0
My Comm.expires July 17,2017
0
Revised 11/16/2016
PERMIT# ISSUE DATE
- PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
MAY .0 3 2@1?
- BUILDING PERMIT
02 SUB-CONTRACTOR AGREEMENT �' P:''.�t!
�l�' Gul",cf/A16)/k/rr lAOWLA �ll�� LJ^') A1 have agreed to be
(Company Name/Individ Name)
the �/ Cy"(�t(�1 Sub-contractor for
(Type of Trade) (Primary Contractor)
For 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. /
CON AC-TORfSIGNATURE(Qi'ualifier) S Oi pORSIGNATURE(Qualifier)
'mil G�CI� c5C® hl" 1 Gt i� t/ kcrytl, 91U;5LMJW`�/
PRINT NAME PRINT NAME
CC CW307-'Z
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER
State of Florida,County of �f_[Al State of Florida,County of i q
The foregoing instrument was signed before me thig—f day of the foregoing instrument was signed�I efore me this A day of
f 1 20 by 20a by
who is personally lwown t or has produced a who is personally known kor has produced a
as identitleation. as identification.
r t
STAMP C r: T1W
P
Signature of Notary PublicSignature
of Notary Public ti•\�"�\5E C.
• �Gpe be5t �
� Dories C. l/irailin m 2
a�O.
Print Name of Not ry Publi Print Name of.Notary Pub * 4Zm'-
2
9FFOM192 '
;9 Q
�W aG 'n Fly If GATES ii,�'!°�e0mfed lMs Aa Q�
Noi4, ;,,:_:.,StatoofFlorida
u, �Ytm+gx,`r,t,' F17588 �Y7�4�11fp±R► ;`'f''
Revised 11/16f2016�.•', J1y 17,2017
PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division C, ; x.
P BUILDING PERMIT CLAY 0 3 20'1?
SUB-CONTRACTOR AGREEMENT _..,.,� ,. .
St.
���159�1n err 6t f71 ma L o n n r 6 l�L iLYL71 have agreed to be
(Company Name/Individ 1 ame) _
the ,_?l u t Sub-contractor for Z apbs/Z'( 1P zi oz.
(Type of Trade) (Primary Contractor)
For 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.
CONtEfACTOR SIGNATURE(Quali a ZOB-CONTRACTORSI TURE(Qualifier)
6a,�Z �- l -5nnle. Cu11;z (e4_snn
PRINT NAME PRINT NAME
2q(o Sq
COUNTY CERTIFICATION NUMBER COUNTY
,,/ COUNTY CERTIFICATION NUMBER
State of Florida,County of___1'// �///t� �t State of Florida,County of n
The foregoing instrument was signed before me th�(�of The foregoing instrument was signed before me this
� �I� day of
r*/ 20�y "O. 5 Co7'7 �/(� Q 20 f 4_,by )_Onfil L I.G.L I b&j�,.W
who is personally known�o//r has produced a who is personally known Zor has produced a
as identification. as' cation.
STAMP P
Signature of tary Pub' ignat a of ota Public
JAC1 Y/`' r WIL`SON
{.i`oe�
.•'1' ......,
#FF15J777
Print Name of No i3r 2c NOVEIM �t�'�1j1
Print Name of Notary Pu is FXPIfIC;S
Adz agg 0153
Pe
i KATHY IL GATES _..._
`r Notary Public,State of Florida
Commission t#FF 17588
Revised 11/16720 My comm.expires July 17,2017
! •
jr•
PLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION
COUNT 2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578
CHANGE OF CONTRACTOR,SUBCONTRACTOR OR CANCELLATION OF PERMT
PLEASE SELECT ONE OF THE FOLLOWING:
CHANGE OF CONTRACTOR—Change of Contractor is to be signed and notarized by the property owner,
and the new contractor of record for the current permit. A new permit application must also be completed with new
contractor information and signature. A new Notice of Commencement must be filed in the new contractor's name
for job values greater than $2,500 ($7,500 if A/C Change-out). A recorded copy must be submitted prior to
commencing any work.There is a$50.00 fee for the Change of Contractor.
CHANGE OF SUBCONTRACTOR—Subcontractor changes are to be signed by the general contractor only.
The new subcontractor must fill out a Subcontractor Agreement Form which is signed by both the contractor and
subcontractor.There is a$50.00 fee for the Change of Sub-Contractor.
CANCELLATION OF PERMIT—The cancellation of a permit is acceptable only if no work has been done.
Cancellation of permit is to be signed and notarized by both the owner and qualifier of record. There is no fee for
cancellation of the permit.
Date: Permit Number:
Site Address:
State License SLC License
Ori al GC,subcontractor or owner/builder
c
State License/� �License
New GC,subcontra or or owner/builder 06 D,`F/� 90191
Reason for Cancellation A-7 `r
The undersigned does hereby agree to indemnify and hold harmless St Lucie County,its officers,agents and employees from all
costs,fees or damages arising from any and all claims of action for any reason,which may arise as a result of this change of
contractor/subcontractor or cancellation of permit.A permit cannot be c elled if work has been performed.
SIGNATURE OF OWNER(or owner/builder) SIGNA GENERAL CCO/�NTTRACT�fOR.(or new GC,a ass,applicable)
PRINT NAME P NAME 5y: /' / /C✓GG(/
State of Florida,County of St.Lucie County State of Florida,County of St.Lucie County
The following instrument was acknowledged before me this Thp following i en clako dg a re me this Ap
day of 20_,by day of 0 IIy \
who is personally known to me who' personally known to
or who has produced as ID. me or who has produced
Signature of Notary Date S i g n a t u r4r 16tary D e
�,, 'P� ANGELA M HUFF
Revised 05/18/2017 �o�"v
Notary Public-State of Florida
Commission#FF 234130
My Comm.Expires May 27,2019
�'%%°;���`� Bonded through National Notary Assn.
PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
EgagoBUILDING PERMIT
WIN w~ SUB-CONTRACTOR AGREEMENT
AE—za, have agreed to be
(Compaily Name/Individual Aame)
the H3)AC===_ Sub-contractor for
(Type of Trade) (Primary Contractor)
_C2- 5-61 -0 5
For the project located at V5 ), ? 3 -(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
2:1
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 RACTOR SIGNATURE(Qualifier) S RA TOR_SIGNAJ(Qualifier)
PRINT NAME P NAME
/ &Lf1sl�_ 9 �
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER
State of Florida,County of nrk' Lj« State of Florida,County of-S�LVC'15_
The foregoing instrument was signed before me this before me this
day of The foregoing instrument was signed b _day of
t-;--—20n by —20L?by
who is personally known_Ce6l�h.produced a who is personally knownL. or has.produced a
as identification. as identification.
jj
STAMP STAMP
SignatuA of Notary Public Signatbre of Notary Public
-0- MARIAH MILLS
Commission#FIF 023763 MARIA H MILLS
Print June 3,2011 Pri Eia 03,
FF 0-23A3
3,2017
Bonded TttteTroy Fain lnsunme800-385-7019
600as 7019
Bonded Thn;Troy Fain Insurence 600a5-7019
Revised 11/16/2016
PLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION
COUNTY 2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578
CHANGE OF CONTRACTOR,SUBCONTRACTOR OR CANCELLATION OF PERMT
PLEASE SELECT ONE OF THE FOLLOWING:
CHANGE OF CONTRACTOR—Change of Contractor is to be signed and notarized by the property owner,
and the new contractor of record for the current permit. A new permit application must also be completed with new
contractor information and signature. A new Notice of Commencement must be filed in the new contractor's name
for job values greater than $2,500 ($7,500 if A/C Change-out). A recorded copy must be submitted prior to
commencing any work.There is a$50.00 fee for the Change of Contractor.
CHANGE OF SUBCONTRACTOR—Subcontractor changes are to be signed by the general contractor only.
The new subcontractor must fill out a Subcontractor Agreement Form which is signed by both the contractor and
subcontractor. There is a$50.00 fee for the Change of Sub-Contractor.
CANCELLATION OF PERMIT—The cancellation of a permit is acceptable only if no work has been done.
Cancellation of permit is to be signed and notarized by both the owner and qualifier of record. There is no fee for
cancellation of the permit.
Date: Z/"`y Permit Number: =611) —
/
Site Address: ���/2�� n�/�f llw tzsox) 'd olge4 9, f�
State License SLC License
Original
GC,subcontractor or owner/builder
/(/4 l 51 State Licensee,9102ff"SLC License
New GC,subcontractor or owner/builder
Reason for Cancellation a 4
The undersigned does hereby agree to indemnify and hold harmless St Lucie County,its officers,agents and employees from all
costs,fees or damages arising from any and all claims of action for any reason,which may arise as a result of this change of
contractor/subcontractor or cancellation of permit.A permit cannot be c elled if wo k has been performed.
SIGNATURE OF OWNER(or owner/builder) SIGNA GENERAL CONTRACTOR(or new GC,as applicable)
PRINT NAME PRINT NAME
State of Florida,County of St Lucie County State of Florida,County of St Lucie County
The following instrument was acknowledged before me this a of wing79!z!
day of 20_by =day ofwho is personally known to me y(mown to
or who has produced as ID. a or who has p oduced as
F ;126
OF
Signature of Notary Date Signature Notary �a??°%�DfffC N ary Public-State of Florida
= w•= Commission# FF 234730
My Comm.Expires May 27,2019
Bonded through National Notary Assn. '
Revised 05/18/2017
PERMIT# ISSUE DATE
PLANNING&DEVELOPMENT SERVICES
Building& Code Compliance Division
BUILDING PERNIIT
SUS-CONTRACTOR AGREEMENT
Total Roofing Systems Specialist have agreed to be
(Company Name/In&vidual Name)
the Roofing Sub-contractor for JWN Construction
(Type of Trade) (Primary Contractor)
For the project located at �P �0` ' 3$(}'' fie 3 �b
(Project Street Address or Property Tax ID#) -J t� jbt5A H
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
Sling of a Change of Sub-contractor notice.
COrACTOR SIGNATURE(Qualifier) ,TRACTOR SIG (Qualifier
�� an Martinez
?rT1 i1�4 �f�1_.t�Yh/il;7 0
PRINT NAMEPRINT NAME
CCC 1330788
COUNTY CERMCATION NUMBER COUNTY CERTMCATION NUMBER
State of Florida,County of �( State of Florida,County of Martin
The foregoing Instrument was signed before me The foregoing instrument was signed before me this 27 day of
201?by , June an by Juan Martinez
who is pe6oly!mown or has produced a who is personally!mown or has produced a
as id lion. as identification.
t
TAMP STAMP
ignatare ofNotar#fublic Signa ure UrN o ary blic
SHARON K.NEWMAN T-9076 C
Fria .21 Print Name of NotaryPubRe
p res prll 20,2021
f'. Dandad Thru Tmy Fain Insurance 800-3857019
ae',GYP ®ialr CE LARA
�=MY COMMISSION#0GO41997
Revised!1/16/2016 EXPIRES October 25.2020
..�
PLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION
COUNTY
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578
CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMT
PLEASE SELECT ONE OF THE FOLLOWING:
CHANGE OF CONTRACTOR—Change of Contractor is to be signed and notarized by the property owner,
and the new contractor of record for the current permit. A new permit application must also be completed with new
contractor information and signature. A new Notice of Commencement must be filed in the new contractor's name
for job values greater than $2,500 ($7,500 if A/C Change-out). A recorded copy .must be submitted prior to
commencing any work.There is a$50.00 fee for the Change of Contractor.
CHANGE OF SUBCONTRACTOR—Subcontractor changes are to be signed by the general contractor only.
The new subcontractor must fill out a Subcontractor Agreement Form which is signed by both the contractor and
subcontractor.There is a$50.00 fee for the Change of Sub-Contractor.
CANCELLATION OF PERIMT—The cancellation of a permit is acceptable only if no work has been done.
Cancellation of permit is to be signed and notarized by both the owner and qualifier of record. There is no fee for
cancellation of the permit.
Date: e—Z_I, / Permit Number:
Site Address: 3r/ c? 91�
State License SLC License
Original GC,subcontractor or owner/builder
State License LC License
New GC,subcontractor or owner/builder
Reason for Cancellation Af)�4
The undersigned does hereby agree to indemnify and hold harmless St Lucie County, its officers,agents and employees from all
costs,fees or damages arising from any and all claims of action for any reaL,whhich may arise as a result of this change of
contractor/subcontractor or cancellation of permit.A permit cannot be cZ
s been performed.
SIGNATURE OF OWNER(or owner/builder) SIGNAT GENERAL CONTRACTOR(or new GC,as applicable)
PRINT NAME P NAME
State of Florida,County of St Lucie County State of Florida,County of St Lucie County
The following instrument was acknowledged before me this The following mstrume was ackpMedged before me this
day of .20_bydaY of ` 20by
who is personally known to me �gy M P� 1-�,0_ on y Ino t
or who has produced as ID. me or who has produced ID.
Signature of Notary Date Signature of otary Date
``SPRY pUBi ANGELA M HUFF
Revised 05/18/2017 r°.�.`� Notary Public-State of Florida
•= Commission#FF 234730
My Comm.Expires May 27,201!
� Bonded through National Nota,-y Assr
PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
Q a
x
0 0 —
_._... BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
have agreed to be
(Company Name/In i 71n
vidual Name) , f
the W" . a�� Sub-contractor for 1 N 16U� QV-1- CL-Q,,
(Type of Trade) z (Primary Contractor)
(�
For the project located at D r� ' � J.� —0 d 4
(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.
CONT CTOR SIGNATURE(Qualifier) SUB-CONTRA OR SIGNATURE(Qualifier)
PRINT NAME PRINT PRINT NAME
IBy1 1 -1) Lq3 �-
COUNTY CERTIFICATION NUMBER
` COUNTY C TIFICATION NUMBER
State of Florida,County of V �'�C�- State of Florida,County of S
The foregoing instrument was signed before me this day of The foregoing instrument was signed before me thisl S day of
ypL?by ,zd 7,by
wh personally known_or has produced a wh ersonally known_or has produced a
as identification. as identification
(-"A < M14v�&��
L- `�C:KJ"�-i STAP STAMP
i ture of Notary Public Aigna a of Notary Public
•::$:^ice.,, MARIAH MILLS
ws.ew�k-, MARIAH MILLS �' *= Commission#FF 023763
Print Name ldi�ires June 3,2017 Prin `
t roy Fete Insuance 80 1r-7M
Bonded Thm Troy Fain Insurance BOM85.700 /:;
Revised 11/16/2016