HomeMy WebLinkAboutSub-Contractor AgreementPLANNING & DEVELOPMENT SERVICES
Building 4 Code -Co.mpliancO.Division
BUILDING PERMIT
SUB -CONTRACTOR AGREESIEN'T
Sr. Lucie County Contractor Certification Number. —
State of r1dridateAification Nu!nber,(vap0i*je):
have agreedtobe the
(Company Nime.,11nd1v'i&a1 ( Name}
sub -contractor for
(Type,6fTra&) (Pc matt'
C_
'ontmeto, r� V
'57?
For the project located, at
(Project Street ,Addressor Property Tax-lD.r4rl)
It is understood that, if there is any change of status regarding. our participation with.thp a,bove,mentioned
project, 1 will immediatelythettldin
g Depart, net1f$t.LUtie.,Cqtntyby-filifgt
Change
of Sub -contractor notice- (Form: SLCCDV,(No. 004-00)
BUSINESS QUALIFIER gName. ofthe bdividual shown on theCofitr*oes Licensd)
SIG! -kTURES.ARE REQL71RFD
Business Namc., C_K� Ate CO f J _Q_C1_LtQA N C
- �: 4 c—
Address-. 96'g OLO C-4 wl L WW4
city'state/zip: 6:
email'
PRINTNAME
ST. Y Q]F- R
TE 0 FLOA IkW, JCOVNM
:TKE FOREGOING 'STUMENT WAS -SIGNED BEFOKE� NIF, THIS. N.'AY QJF 20-
BY S &FtSONALLY KNOWN.
MEIJ SOAD.WROff
EXPAESN6�*r 12i 'M4
.
PRINT NAME OF NOTARY, PUBLIC N617TAP S0*Tfimqv*NQwy3irvt%
SLCPDS: 12/16P2013
PERMIT
# ISSUE DATE
f ,t rye PLANNING & DEVELOPMENT SERVICES
j Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number:
State of Florida Certification.Number (If applicable):
..A k r e 1A 5- ( c--, r!?aAA i J: have agreed to be the
(Company Name/Individual Name) kJ Fu �^ . Sub -.contractor for [/L—zk,
(Type of Trade) ; (Primary Contractor)
For the project. located at.
(Project Street Address or Prope
Tax ID#) 7 2, .co C°C? 3( %
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:.I '~ '�—; C..� L/.4-t
Address:A41
-
City/State/Zip: G c �� Kc<-� !(,. /'" • ?7 rt �j
Phone: �561— � email;
70
SIGNATUREPRINT NAME DATE
STATE OF FLORIDA, COUNTY OF " CC'\
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS DAY OF LC. v C Y , 20 i 5-
By c�10- r c� Y L `C-1 WHO IS PERSONALLY KNOWN OR HAS
PRODUCED AS IDENTIFICATION.
(STAMP)
SIGNATURE, OF NOTARY PUBLIC PRINT NAME OF NOTARY PUBQC
SLCP.DS: 12/10J2013
MICHELEBALL-VAUGHN
MY COMMISSION d FF 049994
EXPIRES:Septemb&21,.2017
•.,,�d�ty?.`•`•� bradedTh. WwyPON;.Uid.-whers
PLANNING & DEVELOPMENT SERVICES DIVISION
BUILDING &. CODE REGULATIONS DIVISION
2300 Virginia Ave
Fort Pierce,. FL'34982
BUILDING PERMIT
SUB -CONTRACTOR SUMMARY
<�' ►�y' ,' i r j will be using the following sub-contractors:for the
(Company/Individual Name) Ay f( /�`
project located at ? } s !' 1 ! ! 3 � /—" `C? I—L. 3ei
(Street address r PropertyTag ID #)
ry ///
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'lrlL
!'Ct:•.
Gas
)FFIC'E 'USE ONIY
PERMIT f'' ISSUE DATE: --
NUMBER:
PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number: _ . . _ 2 Z 1-12-9
State of Florida Certification Number (If applicable): ECA00191rr
� Ce C-+r'tc have agreed to be the
(Company Name/Individual Name)
E I e C-fI<C c)1_� Sub -contractor for. A �
(Type of Trade) (Primary Contractor)For the project located at -�- � -f PE� -e fC�
(Project Street Address or Property Tax ID r)
It is understood that, if there is any change of status regarding our participation With the above mentioned
project, I will immediately advise zhe Building and Zoning.Department of St. Lucie Countv'bv filing a
Change of Sub -contractor notice. (Form: SLJCCDV (No. 004-00)
BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License)
NOTARIZED SIGNATURES ARE RTQUIRED
Business Name: TA.J&U-% eW4_ , L. "f'. c..y
STATE OF FLORIDA, COUNTY OF '
rip
THE FOREGOING INSTRUbIIENT WAS SIGNED BEFORE ME THIS DAY OF _ l VL AA�LC , 20
BY WHO I ERSONALI 7' KNO� n OR HAS
PRODUCED -_ AS IDENTIFICATION.
(STAMP)
SlGlfftffy OF NOTARY PUBLIC PRINT NAME OY NOTARY PUBLIC
SLCPDS: 12/I 6/2013 �'�r •U
so � ••• ,k�, Nr1NCYbAu•RIOIIX
* ; MY COMMISSION i FF 03�68i'
EXPIRES; October 29, 2017
�''rEor " BoedeiThru Budget NobryServices