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PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
� . Building & Code Compliance Division
COUNTY
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
St.Lucie County Contractor Certification Number: G.0 U
State of Florida Certification Number(If applicable):
ma-�& _ .2.a-1(:1L have agreed to be the
��-(( ��(C,,,o`m`p�,a�ny Name/Individual Name)
L�i� __k`( u— Sub-contractor for S
(Type of Trade) (Primary Cont ctor
For the project located at Al5E2 US 1
(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, 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: Q
Address:
City/State/Zip: Z
Phone: 2— ,Q�— email: C1 ' • Yl
NcA&.,
SI TURE PRINT NAME DATE
STATE OF FLORIDA,COUNTY OF �� b,),C,*U--,,
THE FOREG ING INSTRUMENT WAS SIGNED BEFORE ME THIS �'�DAY OF 0 VU ,201,15
BY_ WHO IS PERSONALLY KNOWN OR HAS
PRODUCED AS IDENTIFICATION.
bck ` 1��� EKaAa Ilk A n (STAMP)
SIGNATURE OF NOTARY PUBLIC PRINT NAME OF NOTARY PUBLIC
SLCPDS:08/06/2014
BRENDA MARTINEZ
Notary Public-State of Florida
My Comm.Expires May 31,2015
Commission#EE 98807
•
PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
- `- - Building & Code Compliance Division
•
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
St.Lucie County Contractor Certification Number:
State of Florida Certification Number(if applicable): I H 1025264
QUALITY HOMES/DWIGHT DOUGLAS have agreed to be the
(Company Name/Individual Name)
PLUMBING Sub-contractor for DWIGHT DOUGLAS
(Type of Trade) (Primary Contractor)
For the project located at 4155 N US HWY LOT 78, FT PIERCE
(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, 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: Po-,,_4 43��Address: 47 5 ELES ES
City/State/Zip: LAKELAND, FL 33810
Phone: 863-608-2670 email: nancyarmstrong6l@gmail.com
/Ij�_ Atvct,�) DWIGHT DOUGLAS 11/20/2014
I NA RE r PRINT NAME DATE
STATE OF FLORIDA,COUNTY OF POLK
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS 08 DAY OF DECEMBER ,2014
BY DWIGHT DOUGLAS WHO IS PERSONALLY KNOWN X OR HAS
PRODUCED FLDL AS IDENTIFICATION.
NANCY MIMS ARMSTRONG (STAMP)
SIGNATUR F NOT PUBLIC PRINT NAME OF NOTARY PUBLIC
SLCPDS:08/06/2014 NANCY MI` ARMSTRONG
MY COMMISSION#EE059652
•',¢�,, o F EXPIRES January 30,2015
407)39E-1188 FlorideNota Service.com
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
• Building and Code Regulations Division
BUILDING PERMIT
SUB-CONTRACTOR SUMMARY
DWIGHT DOUGLAS will be using the following sub-contractors for the
(Company/Individual Name)
project located at �10 HWY1 , LOT7 g FT PIERCE
(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.
St. Lucie County/
Trade Name of Company/Contractor State of Florida
License Number
AT
Electrical
M ULA ELECTRIC EC13001643
JAMES MATULA
Plumbing QUALITY MOBILE HOMES IH1025264
DWIGHT DOUGLAS
HVAC/ N/A
Mechanical
Roofing
Gas
OFFICE USE ONLY:
PERMIT ISSUE DATE:
NUMBER: I4�
Revised 07/29/2014