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HomeMy WebLinkAboutSub-Contractor AgreementPLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION UNTY BUILDING PERMIT • • SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number:��a gy State of Florida Certification Number (If applicable): op, 13 i7 I µ O �} C_ have agreed to be the (Company Name/Individual Name) , �LOsub -contractor for � �-- (Type of Trade) (Primary Contractor) for the project located at 4s-b-z --Ub� — t��bA -bib (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) ORIGINAL SIGNATURES ARE REQUIRED SIG ATURE Business Name: Address: City/State/Zip: Phone: OFFICE USE ONLY: �Lwy 4- Goa✓ PRINT NAME DATE 7 © - �L3,5-7 email: PERMIT # ISSUE DATE 1 ~ \ PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION BUILDING PERMIT SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: GY� ��- State of Florida Certification Number (If applicable): P)C— 1 1061372- Jw,I en Bach Plumbs no, Ine, • have agreed to be the (Company Name/Individual Name) Plumb! nQ sub -contractor for 0 00nbJnvd'on (Type of T ) (Primary Contractor) for the project located at Q�— EN — dt�Iu4 — (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) ORIGINAL SIGNATURES ARE REQUIRED CRT-l�nniP 'I I�P�rt��n GNATURE PRINT NAME DATE Business Name: jENSEN BEACH PLUMBING, INC Address: I 0RoWE Industrial Blvd- City/State/Zip: Tensen Beach, FL 34957 Phone: (772) 225-6600 email: X 6F1umbm4@bI1S V1h .ref' OFFICE ITSF ONLY: PERMIT # ISSUE DATE PLANNING & DEVELOPMENT SERVICES DEPARTMENT _ BUILDING & CODE REGULATIONS DIVISION BUILDING PERMIT o _ SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: 0 5T oc2- State of Florida Certification Number (Ifapplicable): e-m e- '_Uvca a A4ay t have agreed to be the (Company Name/Indl Name) � sub -contractor for L��1 C'�t� (Type of Trade) I (Primary Contractor) i for the project located at ` ,,`` � DI (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) O GINAL SIGNATURES REQUIRED 1%jA (VC'e �� �O✓L� � ���� SIGNATURE PRINT NAME DATE Business Name: Address: City/State/Zip: Phone: d-%1VWT1--V 1rTQ1W nNT .V- email: l!1'A: X%,A' v-- v ISSUE DATE PERMIT # PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION BUILDING PERMIT SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: State of Florida Certification Number (If applicable): �e- l% & 9 vG� 11 :rd cz- , have agreed to be the (Company Name/Individua ame) p (' ►, sub -contractor for : LJA� 0_&A- ic�776 _ (Type of Trade) (Primary Contractor) for the project located at-4©2'��� (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) ORIGINAL SIGNATURES ARE REQUIRED SIGN/dUW PRINT NAME DATE Business Name: -�t7� 0- Address: ,n0 rTl*) O K! 1 7 .S City/State/Zip: 3 4 Ci 9 Phone: c$ J-D i 6 email: OFFICE USE ONLY: PERMIT # ISSUE DATE 0-0 -Cott Nlry, PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION 2300 VIRGINIA AVENUE 'FORT PIERCE, FL 34982-5652 (772)462-1553 FILLED LANDS AFFIDAVIT I, the undersigned, am the owner of the following described property, L6D2 9Ol-1bbO� - -9 (Parcel I0/Legal description/Address) for which I have applied to St. Lucie County for a Final Development Permit. In accepting this Final Development Permit, BP Number , I acknowledge that as owner of the above described property, and in accordance with Section 7.04.01(D), St. Lucie County Land Development Code, I shall be responsible for assuring adequate drainage so that the immediate community WILL NOT be adversely affected. I further acknowledge that in granting this permit for the development of this property, St. Lucie County is neither obliged nor liable to provide for, or maintain in any form, adequate drainage off my property which will not adversely affect the immediate community. ��= Lew) ) DNS Property wner Na (Please t) Property Owner Signature Date STATE OF FLORIDA, COUNTY OF T—,* =I� ACKNOWLEDGED BEFORE ME THIS Jq DAY OF 20 BY WHO IS ERSONALLY KNOWN TO OR WHO HAS PRODUCED AS IDENTIFICATION. IGN WNOTARY PUBLIC TYPE OR PRINT NOTARY COMMISSION NUMBER MARIAH MILLS la't 3PSAL)Commission # FF 023763 Ex Tres June 3, 2017 BondedTh, Fim1murance8*3867019 SLCPDSD Revised 08/24/2010