HomeMy WebLinkAboutLot 1 TF Sub Contractor forms 9.8.2021PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
• Building and Code Regulations Division
BUILDING PERMIT
SUB -CONTRACTOR SUMMARY
AJT Construction Consulting LLC will be using the following sub -contractors for the
(Company/Individual Name)
project located at 3937 Shoreside Drive 1423-566-0004-000-9
(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
Adams Electrical
EC13006096
Plumbing
Meeks Plumbing
615_ 137�-
HVAC/
Delair Heating and AC
27191
Mechanical
CAC032448
Roofing
Walsh Roofing
CDC1330084
Gas
N/A
OFFICE USE ONLY:
PERMIT ISSUE DATE:
NUMBER:
Revised 07/29/2014
PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
Name)
the
(Type of Trade)
For the project located at
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
i
Sub -contractor for
(Prole,ct Street A ess or Prope6 Tax ID #)
/Z V / have agreed to be
Contractor)
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 SIGN (Qualifier)
IRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County 04�_
The f egoing instrument was signed before me this�/j�� �'!_ day of
4q;�k 2Q� by "Al) �C Gfa
who is personally known _or has produced a
as idendfication.
Signature of Notary Public
V&5 / >
Print Name of Notary Public
FRANCES DONZA
MY COMMISSION # HH 111471
:•;rPo EXPIRES: July 27, 2025
Fa! FAO ` Bonded Thru Notary Public Underwriters
S -CONTRACT SIGNATURE (Qualifier)
PRINT NAME
�/1 1(3ao �09�
COUNTY CERTIFICATION NUMBER
State of Florida, County of
The f oing instru nt was sigued before me this / day of
2 ,by
who is personally known _or has produced a
as identification.
STAMP STAMP
Signature of NotaryPublic
FRANCES DONZA
MY COMMISSION # HH 111471
EXPIRES: July 27, 2025
Bonded Thru Notary Public Underwriters
PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
S
(ConYpany Name/Individual Name)
the �"h_J �3 Sub -contractor for
(Type of Trade) e
For the project located at
have agreed o be
(Admary ontractor)
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, the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the
filing of a Change of Sub -contractor notice.
11
CONTRACTOR SIGNATURE (Qualifier)
4� w �f
YI
T NAME 9A
n M a . I <n 4)pc:u
COUNTY CERTIFICATIONNUMBER
State of Florida, County of I
he foregoing instrumeYby
2
sign fore me th� day f
/ 0
who is personally known or has produced a
as identification.
-Sigha4uFe-of Notary Public
Print Name of Notary Public
' �; Y :, ..• MY COMMISSION # HH 111471
Jul 27, 2025
EXPIRES: publicUnderwrlters
a�`•1. gondedThouNotary
Revised"'1,1,/?16/2016
�U&tONT CT, R SIGNATURE (Qualifier)
j' , ��Cix f LV Ja h
PRINT NAME
OUNTY CERTIFICATION NUMBER
- State of Florida, County of�
T e re ing i4stru ment wahs signed before me this d y o
wbo is personally knownor has produced a
as id en cation.
STAMP STAMP
Sig uatu a of Notary Public
&J
Print Name of Nota Publk,
FRANCES DONZA
MY COMMISSION # HH 1"471
EXPIRES: July 27, 2025
-S 't Bonded Thru Notary Public Underwrlters
PERMIT # I I ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
For the project located at
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 pursua" the
filing of a Change of Sub -contractor notice.
"�Az-��
NTRACTOR SIGNATURE (Qualifier)
PRINT NAME
COUNTY CERTIFICATIONUMBE
_� Aw,
State of Florida, Couof a& V`--"
Th oregoing Instrument was signe eef/ore me this day of
who is personally known _ or has produced a
as ident;;�4v
STAMP
Signature of Notary Public !�
/�� 't�s o w
Print Nana of Notary Public
•;��51Y PU •• FRANCES DONZA
MY COMMISSION # HH 111471
a• V EXPIRES: July 27, 2025
'•'Fos F °Q' Bonded Thru Notary Public Underwriters
Revised 11/
Russo
/ 'J!4 ( a -IS
COUNTY CERTIFICATION MBER
State of Florida. County of
ITfore ing intlirumerAN signed befor met is ��d�a�y of
/
who is personally known V or has produced a
Signature of Notary Public
L-A-IS 66
Print Name of Notary Public
FRANCES DONZA
••.......C'•.
.; MY COMMISSION # HH 111471
EXPIRES: July 27, 2025
o:
F ° ' Bonded Thru Notary Public Underwriters
STAMP
PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Meek & Sons Plumbing, Inc have agreed to be
(Company Name/Individual Name)
the Plumbing Sub -contractor for phoenix Custom Homes
(Type of Trade) (Primary Contractor)
For the project located ' dg3 r%
krroject 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, the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the
filing of a Change of Sub -contractor notice.
CONTRACT/OR SIGNATURE (Qualifier)
P INT NAME.
COUNTY CERTIFICATION N SER
State of Florida, County of�tXG,/`
J;fore=ment was signed before me this / day of
21 z by V&4)�
who is personally known _ or has produced a
as
Signature of Notary Public
t<( y' •., FRANCES DON
'�, : MY COMMISSION # HH 111471
�;.•a< EXPIRES: July 27, 2025
''•'Fore°Q' Bonded Thru Notary Public Underwriters
Revised
SI-CON7'RA(-rR IGNATUR-E (Qualifier)
David Meek
PRINT NAME
CFC057372
COUNTY CERTIFICATION NUMBER
State of Florida, County of Indian River
The foregoing instrument was signed before me this day of
September 2021 by David Meek
who is personally known or has produced a
as identifica lion.
a
STAMP S'I`A11P
Signature a Nata y Public
Abigail Lefebure
Print Name of Notary Public
var.� Noy,ry Public Slate of FVida
ft
Abigail E Lefebure
My Commission HH 120167
�+ ' Expires 04P21t2025
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