HomeMy WebLinkAboutSub agreementsPLANNING 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 4297 N HWY 1, LOT 120 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, 1 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
MATULA ELECTRIC
EC13001643
JAMES MATULA
Plumbing
QUALITY MOBILE HOMES
IH1025264
DWIGHT DOUGLAS
IIVAC/
N/A
Mechanical
Roofing
Gas
OFFICE USE ONLY:
PERMIT ISSUE DATE:
NUMBER:
Revised 07/29/2014
PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
-I - -` Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number:
State of Florida Certification Number (if applicable):
IH1025264
QUALITY HOMES/DWIGHT DOUGLAS
have agreed to be the
(Company Name/Individual Name)
PLUMBING Sub -contractor for DWIGHT DOUGLAS
(Type of Trade)
For the project located at
(Primary Contractor)
4297 N US HWY LOT 120, 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 SIGNATU
Business Name:
Address:
City/State/Zip:
Phone:
4775 ELES CRES ( I
LAKELAND, FL 33810
863-608-2670
Jn4'6�n�_
SI ATUR
email: nancyarmstrong6l@gmaii.com
DWIGHT DOUGLAS
PRINT NAME
STATE OF FLORIDA, COUNTY OF POLK
03/08/2015
DATE
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS 08 DAY OF MARCH
BY DWIGHT DOUGLAS WHO IS PERSONALLY KNOWN X
DUCED FLDL AS IDENTIFICATION.
NANCY MIMS ARMSTRONG
SIGNATUR F NOTARY PUBLIC PRINT NAME OF NOTARY PUBLIC
SLCPDS: 08/06/2014
2015
OR HAS
(STAMP)
.. . NANCY MUS ARMSTRONG
*: My COMMISSION O FF197M
EXPIRES F*brusry 10. 2019
cwr
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
COUNTY
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number: 205C)l
State of Florida Certification Number (if applicable): t�
(compiny Name/Individual Name)
Sub-contractor for
(Type of Trade)
have agreed to be the
M-4-a Lk
(Primary Contra r)
For the project located at ]�Lu 4-)-ql IN 1 QS I
(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:
Address:
City/State/Zip:
Phone: �2
UNE M�Iqvv
4WD Mm_
�► _� _ ��%
,c- Ma ��2gft;�� -,,� :7m� —
3_q,is
SIG URE PRINT NAME DATE
STATE OF FLORIDA, COUNTY OF
THE FO GOING INSTRUMENT W S SIGNED BEFORE ME THIS CAY OF rC V \ , 20 L/
BY WHO IS PERSONALLY KNOWN_ OR HAS
PRODUCED
AS IDENTIFICATION.
?)oema, M(A-L aLeociL_ MUL-6QZ
SIGNATURE OF NOTARY PUBLIC PRINT NAME OF NOTARY PUBLIC
SLCPDS: 08/06/2014
(STAMP)
BRENDA MARTINEZ
n Notary Public - State of Florida
N : My Comm. Expires May 31, 2015
o;
;'FOF, o;:,' Commission # EE 98807