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HomeMy WebLinkAboutSubcontractor Agreement i RECEIVrD MAY 04 2017 •• •• g� PLANNING & DEVELOPMENT SERVICES DIVISION BUILDING&CODE REGULATIONS DIVISION ® 2300 Virginia Ave Fort Pierce,FL 34982 BUILDING PERMIT SUB-CONTRACTOR SUMMARY will be usingthe following sub-contractors for the g (Company/Individual Nam ) ^� project located atk1 / (Street address or Property Tax ID#) V 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. St. Lucie County/ Trade Name of Company/Contractor State of Florida License Number Electrical / l`-P©��� /9 ��� �s 6 PlumbingZP40WAe-W6 - HVAC/ Mechanical Roofing Gas OFFICEUSE;ONLY PERMIT ISSUE DATE: NUMBER: RECEIVED MAY 0 4 .2017 r -� PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION z. BUILDING PERMIT o SUB-CONTRACTOR AGREEMENT St.Lucie County Contractor Certification Number: �® T / State of Florida Certification Number(If applicable): / � =:�Y 6 ` /"!�1-14-A - 4�,/) / have agreed to be the (Company Name/Indiv' ual Name) ,J sub-contractor for d (Type of Trade) (Primary Contractor) for the project located at P1zq 7 A�AL L2 ( roject 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 personally filing a Change of Contractor notice. (Form: SLCCDV No. 004-00) BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License) ORIGINAL SIGNATURES ARE REQUIRED SI NATU PRINT NAME DATE Business Name: 4e I-Y Address: 0 City/State/Zip: 7— v Z Phone: :�S- - a email: OFFICE USE ONLY: [--PERMIT# ISSUE DATE i RECEIVED MM p4.2011 r a �VILDlf�t�;i E%ld$I<T ' ,cy M-CONIRAM, .AGREEME ' St Lucie County CoMmotor Certification:14dmber. State of f=loridd Cwfificatlofi 6dumber(It dpplicablej: 9 -------------- ail ;. .Po ,~... •..• .. 1.1. '.� IJI+ ILL has:agreed to%be :(oompdnyJfpdM6'sinar ) `:! the n$a ct®r: ory :Q -A (type'Rf oonstWdlon triide) : ' : ..(name oQ tfi®`prirrt9 contrador) for the project located at ® ��V. :y' •It:is-understood the' t' ; (street addreat or propeity lax fD#) if there is any charige of status regarding our parficipatiion.'w th the above Mentioned project, I will immediately advise the Commi.1611Y Mevlbloprhent Depadmont (Growth r Management:bivision :of St. �.ucio;Cquh b rsq:rlall :M-16� 6 Char e.:bf Contractor 9 tD' Yp . Y� g . g. Fomn (SLCCDV FORD Id.O:•C ' -00t. • •' ailmd*ar+'aAaai+m,a;,.a:s::� ,e-1 (origlnelslgridfured tequired): BU$IN QU'A sign4t) :. print name'. j . date business na e: '•' • Z G d'a address: .'2ws 0 ! - At -.-.LkJS AI city,state,zip: .'ti' i' '' Cif I L : =`� ' phone: ' •Z - sLCCDV FORM NO.:002-00 PERMIT 9 ISSUE DATE