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HomeMy WebLinkAboutSubcontractor agreementsPLANNING & DEVELOPMENT SERVICES DIVISION BUILDING & CODE REGULATIONS DIVISION 2300 Virginia Ave Fort Pierce, FL 34982 BUILDING PERMIT - SUB CONTRA _��`�c I I G -will be using the following sub-contraetors for the - _1b (Company/Individual N me) - - ---- -- ..-�rojectlocated at (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. Trade _ Name of Company/Contractor St: Lucie County/ State of Florida License Number Electrical Plumbing HVAC/ Mechanical Roofing C Qf - Gas Y: PERMIT NUMBER: ISSUE DATE: �''i��- ��L� PL Vilding ING & DEVELOPMENT SE VICES & Code Compliance Dion BUILDING PERMIT SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: State of Florida Certification Number (If applicable): (Company Name/Individual Name) elt C I j U-GL sub -contractor for (Type of Trade) have agreed to be the (Primary Contractor) for the project located at ) � . � iUe+4 lc S A I uc , aw z �en 6ec.c L F1 (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 ofthe Individual shown on the Contractor's License) NOTARIZED SIGNATURES ARE REQUIRED Business Name: Address: IJ h- / NQT'tle C InI U&I .J-fej%to f-3QaeMI rt_ City/State/Zip: S G k Gc u Ste") Phone: % 7 ,� �3 — 6�a email: S U_ i=m �_4/�1 ► • C' O /✓► ICA_ a ao1_1� SIG TURE PRItTINAME DATLf STATE OF FLORIDA, COUNTY OF /! THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS 6 DAY OF , 20-&— BYvi,i&N((J WHO IS PERSONALLY KNOWN _ OR HAS PRODUCED IDENTIFIC IO (STAMP) I IGNATU OF N ARY P LIC PRINT OF NOTARY PUBLIC OFFICE USE ONLY: PERMIT # AUDREYO.HUMPHREY MY COMMISSION N EE 061159 EXPIRES: March 5, 2015 Bonded TM NAVY i ubl4t IJndel�` a PL Auilding NING & DEVELOPMENT SE VICES & Code Compliance lion BUILDING PERMIT SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: State of Florida Certification Number (If applicable): G Name/Individual Name) sub -contractor for (Type mde) for the project located at la 6 -) /Vey )e c 12L (Project Street Address or Property Tax ID have agreed to be the (Primary Contractor) rL `1iS;� 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 ofthe Individual shown on the Contractor's License) NOTARIZED SIGNATURES ARE REQUIRED Business Name: Address: City/State/Zip: Phone: 77a-3w-969-a ,(t 1, (_L rn a dC)r s. I ATURE PRM NAW DA E STATE OF FLORIDA, COUNTY OF THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS. & DAY Wlk - , 20_ "O IS PERSONALLY KNOWN _ OR HAS PRODUCED STAMP) A "61,ENTIFIC r tv GNAT E NOT RY P LIC ;;li PRINT OF NOTARY PUBLIt AUDREy8g. HUMPHREY MY COMMISSION # EE o1159 EXPIRES: March 6, Bonded Thru Notary Public U_� ltery OFFICE USE ONLY: PERMIT# ISSUE DATE