HomeMy WebLinkAboutSub-Contractor AgreementPLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT ,
St. Lucie County Contractor Certification Number: J
State of Florida Certification Number
11
U E . have agreed to be the
(Company NatfileAndividuil Name)
k(�L sub -contractor for
(Type of Trade) (Primary Contractor) ,
for the project located at ,�a o(.J a (,k� P W t)
(Project t eet 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 personally filing a Change of Contractor notice. (Form: SLCCDV
No. 004-00)
r
BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License)
ORIGINAL SIGNATURES ARE REQUIRED
Q6,)r,. S Z obi rJ L 411 � /1�
SIGNATURE PRINT NAME D TE
Business Name:
Address:
City/State/Zip:
Phone:
OFFICE USE ONLY:
PERMIT # ISSUE DATE
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PLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
9 9 BUILDING PERMIT '
e - SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number: 16568
State of Florida Certification Number afappiicabl,): EC0001693
Ault Bros, Inc/Michael Dale Ault have agreed to be the
(Company Name/Individual Name)
Electrical sub -contractor for
(Type of T{ade)
Walter Moon
(Primary Contractor)
for the project located at 22 Aqua Ra Dr., Jensen Beach, Fl 34957
(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 personally filing a Change of Contractor notice. (Form:. SLCCDV
No. 004-00)
BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License)
Business Name:
Address:
City/State/Zip:
Phone:
chael Dale Ault 1/3/2014
T NAME DATE
Ault Bros, Inc.
PO Box 1528
Port Salerno, FL 34992
772-283-5520 email: aultbros@yahoo.com
OFFICE USE ONLY:
PERMIT # ISSUE DATE
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ST. LUCIE COUNTY PUB]GIC W010'"
BUILDING & ZONING DEPARTIV�Et'
BUILDING PERNWr
SUB -CONTRACTOR AGREEMENT
Connector Ce dlication Number:
33 S. '
St. Lucia County
Stato of Florida Certification Number tUwtffcabkl- II
VL
(CanipanyNameltadtvidual Name)
(J�M,� 1 ✓LE, sub- contractor for v✓f14-
( [I W of Trade) (primary Contract
for the project located at
(Project Street Address or Property Tax ID 1.1
i
It is understood that, if there is any change of status regarding our is
above mentioned project, I will immediately advise the Building air
of St. Lucie County by personally filing a Change of Contractor nO
No. 004-00)
BUSINESS SS QUAUF IER (hare of the individual shown on the C
Address: c
City/Statelzip: ��� �V-�
Phona- 7 Za - 6 0-Y =�
r-<e_F-r- ! S
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Dated: _r ems
the
with the
Department
r. SLCCDV
PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number: R 3Q1-1 1 / /
State of Florida Certification Number (If applicable): ��C 13c-2 & 5 _7`-i
,/as E . ;tee..
(Type of
For the project located at
ividua(Name)
W
Sub -contractor for
(Project Strbet Address or Property/Txl ID
(Primary Contractor)
have agreed to be the
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: �] % email:
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1 110 I ( q
S GN URE PRINT NAME DATE
STATE OF FLORIDA, COUNTY OF1�
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS DAY OF C .20 /A -
BY OV f WHO IS PERSON (�lKNOWN _� OR HAS
PRODUCED AS IDENTIFICATION.
A R%__ ��E_ _9&,e_C
SIGNAT . RE OF NOTARY P C - PRINT NAME OF NOTARY PU LIC �' c
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SLCPDS: 12/16/2013 # 1071345
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