HomeMy WebLinkAboutSubContractor Summary kablerPLANNING AND DEVELOPMENT SERVICES DEPARTMENT
Building and Code Regulations Division
BUILDING PERMIT
SUB -CONTRACTOR SUMMARY
AJT Construction Consulating LLC
will be using the following sub -contractors for the
(Company/Individual Name)
project located at 4912 water Song Way
(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
Carney Electric
EC-13012944
Plumbing
The Plumbing company
2017
HVAC/
AC Care
31900
Mechanical
Roofing
Micheal Kevin Walsh Roofing
CCC1330084
Gas
Como Gas
05594
27064
OFFICE USE ONLY:
PERMIT ISSUE DATE:
NUMBER:
Revised 07/29/2014
PERMIT # ISSUE DATE
i ylf P�1 Wiz,
Ct3Cl NTY
F L O R I D A
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
� E k r' N 0q ummy have agreed to be
(Company Name/Indivi al Name) (�
the 1 Sub -contractor for ,� 1'C�(�,� d I ► us
-(Type of Trade) (Primary Contractor)
For the project located at ` f i' wkr4' w1 46
(Project Street Address or PrqiptftTax 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.
CONTRACTOR SIGNATURE Aualifier)
PRINT z
NAME / %� t�
�JVe - L cJ a 3 1p� /
COUNTY CERTIFICATZA6b�
State of Florida, County
The foregoing instrument was signed before me this day of
20_:Z,by
who is pers ally known _or has produced a
Revised 11/16/2016
SUB -CONTRACTOR SIGNATURE (Qualifier)
11)
Jp A0J
VTRINTT/ NAME
1-0I ^/ `-1 n
COUNTY CERTIFICATION 7MBER
State of Florida, County of
The foregoing instrument was sig ed before me this day of
20 , by
who is personally known _or has produced a
as iden 'fication.
C14 / A41-x� STAMP
Signnat//re of Notary PbliuJ
/ei� l //� S / J/)
r av Notary Public State of Flotilla
Frances Dotza
My Comrnlsawtr
GG 092440
Expires 0712712021
own"OPPIT-�
COUNTY
F L O R I D A
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
(C mp y Nar�/Individual Name)
theP /1i r'.Cl,nl/ Sub -contractor for
(Type of Trade)
For the project located at
(Project Street Address or Properl&Tax ID #)
have agreed tQ be
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.
NTRACTOR SIGNATURE (Qualifier)
�JI
PIM NAME
�&- 1 Ea
COUNTY CERTIFICATION NUMBER
State of Florida, County of U— ty
he foregoing instrument was signed before me this day of
20,.?/, by --a L" 7 0
who is personally known _or has produced a
as identi cation.
STAMP
gnats a of Notary Publi
'0� _ /"� _ .
Print Name of
Revised 11 /16/2016
.rift Notary Public Stale of Florida
Frances Uonza
c �p� My commission GG 092440
Expires 07/27/2021
';R?,
OUNTY CERTIFICATION KUMBER
State of Florida, County of18 ! l�L�L.tuo—
The foregoing instrument was signed before me i�V day of
�SLLw , 2al , by
who is personally known or has produced a
as iden ification.
a— STAMP
Signature of Notary Public//
Print Name of Notary Pub*
r Notary Public State of Florida
y4 Franc8S Donza
7, pa my Commission GG o92440
�j Of Expires 0712712021xhPV
LL(�
PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
�ls h
(CoWany ame/Individual Name)
the
For the project located at
Sub -contractor
'Vgla
(Project Street Address or Property Tax ID
- have agreed to/- �jbee
am 01
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.
"�'- "--41_�
NTRACTOR SIGNATURE (Q lifier)
�/0
PRINT NAME
54/
COUNTY CERTIFICATION MBER n
State of Florida, County of �G y
The foregoing instrument was signed before me this %� day of
u— 20;2\ by .C.fl�)V �a�
AV —
who is personally known �or has produced a
as identification.
Print Name
.,%Y N NotaryPublic Ste;e o1 Florida
Frances Dona
c �P My Commission GG 092440
pfpa' Expires 07/2712021
Revised 11/16/2016
B tONTIR ACR SIGNATURE (Qualifier)
( (.tl 164
CC
State of Florida, County of
The f regoing instrument was sign fore me this day off 1
2d` by (/.(/e (n. is
who is personally known v or has produced a
as identification.
STAMP
Signature of Notary Pub is
Print Name of Note Pu li
Apr Notary Public Stara of Florida
$ Frances Dona
Cormnission GG 09244G
��'OF R Expires 07/271202I
STAMP
PERMIT # ISSUE DATE
7F?97MR�lY
D A --46
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to be
(Company Name/Individual Name)
the HVIK, Sub -contractor for
(Type of Trade)
For the project located at y % oZ - (�(/L%MR0,02
(Project Street Address or Property Tfi 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 ACTOR SIGNATURE (Q lifier)
,v 1�
LINT NAME:
COUNTI• CERTIFIC:I'1'ION NUMBER
State of Florida, Counh ofl��J�—t/
Abe
foregoing instrument was signed before me this day of
by
who is personally known J or hasp roduced a
—
Tntification.
Signature of Notary Public
l:::;e 1U`s
Print Name of Notary Public
�{ Notary Public Stara of FlotidH
C, nces DOnZa G 091446
,Rinsed l/16/2U� CointnissionG1
ti sa Expires 071271202
y."v
— C'�
SUB-CONT , CTOR SIGNATURE (Qualifier)
m
PRINT NAME
ls� Ci 00
COl'NTY CERTIFICATIONVl'MBER
I^
State of Florida, County of I` It+i, A
Theforegoing instrument was signed before me this
eI day of
RJONOLN 202Aby ` �Y1a1f�L 1�U
who is personally known _or has produced a
as identification.
STAMP STA M P
Signature of No
W,
�Yl PINZON
Print Name of Notaky Pub is : ;++►J-
=F•' `t MlSS10N # GGoSr
2011
MY GOM
' 2021
EXPIRES March 22.
•.?are;
PLANNING & DEVELOPMENT SERVICES
COUNTY
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number: ;� 3LO 6 4
State of Florida Certification Number (If applicable): g ng L s egm-se OSS 9 y
(Company Name/Individual Name)
1 - CAA _S Sub -contractor for
(Type of Trade)
For the project located
(Project
or Py Jperty Tax ID #)
Contractor)
have agreed to be the
�Al�,e- L/z
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: 772 —.2 Q XT. 9 00 email: Lh kW * o�ao AaA i N . ClOp^,
SIGN RE PRINT NAME ITT
STATE OF FLORIDA, COUNTY OF
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS /O DAY OF 20 !/
BY z WHO IS PERSONALLY KNOWN OR HAS
PRODUCED AS IDENTIFICATION.
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Y U T
SIGNATURE OF N PRINT NAME NOTAR0
ARY PUBLIC
sip
SLCPDS: 08/06/2014 f �•'Ko<<
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