HomeMy WebLinkAboutSUB-CONTRACTOR SUMMARY16 C St. Lucie County
�J Gym Building & Zoning
. ��ORIOp BUILDING PERMIT
SUB -CONTRACTOR SUMMARY
t�z``n"deis)J 20v Vito ?_)l iviff be using the following sub -contractors for the
(Company/Individual Name) .�
project located at
)�
(Street address or Property Tax ID 4)
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
teti,1
p2i oZ�
Plumbing
900 6J�SG Cltkc1�
L,c,
j 3%
Mechanical
r�7So sit gE , 6-eC S- Z�-
-1� �_3`t
s I
Roofing
l -7� q S Ck
Gas
OFFICE USE ONLY:
PERMIT ISSUE DATE:
NUMBER:
ST. LUCIE COUNTY PUBLIC WORKS
i BUILDING & ZONING DEPARTMENT
��ORIOP
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number:1��o d)1 01-2)
State of Florida Certification Number (If applicable): 0 W 0 0 ��
o�� �l i Lill �� �l �C� . �-�1� • have agreed to be the
`(Company Name/Individual Name)
�tcri sub -contractor for
(Type of Trade) (Pr' ry Contractor)
for the project located at bA4
b�2J
(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 REOUIRED
SIGNATURE PRINT NAME DATE
Business Name:�Q ' �C�• , .
Address:
City/State/Zip: Pik J
Phone: Y—) email:
OFFICE USE ONLY:
PERMIT # ISSUE DATE
ST. LUCIE COUNTY PUBLIC WORKS
BUILDING & ZONING DEPARTMENT
� OR1�P
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number: 4 1
State of Florida Certification Number (If applicable): 0, 0 c� j
h
t, sg-have agreed to be the
(Company Name/Individual Name)
A
......__.- _U" U •sub -contractor --for ate,
(Type of Trade (P ' Contractor)
r
r
for the project located at .7-
.-
(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 AU
1J90UIRED
PRINT N (1l DATE
Business Name:
Address: 1
City/State/Zip:
Phone: (�? a J — (0 email:
OFFICE USE ONLY:
PERMIT # ISSUE DATE
` ST. LUCIE COUNTY PUBLIC WORKS
y BUILDING & ZONING DEPARTMENT
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number:
State of Florida Certification Number (if applicable): 1 � 0 d'-7 O 'Rf7
C .—A - tNc �
(Company Name/Individual
have agreed to be the
� sub -contractor for
(Type of Tiade) (Primary Contractor)
for the project located at
(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. 604-00)
BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License)
ORIGINAL SIGNATURES ARE 11EQUIRED
PRINT NAM
Business Name:
Address:
City/State/Zip:
Phone:
OFFICE USE ONLY:
DATE
ST. LUCIE COUNTY PUBLIC WORKS
BUILDING & ZONING DEPARTMENT
�ORI�P'
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number: �t �, I JC�
State of Florida Certification Number ff Rpticabte): ,� (Cc�G-76__� 2—
Ei.LE' have agreed to be the
mp y ame/Individual Name)
l�h -.... ___,.__sub7contractor for.
(Type Trade (Pr' ry Contractor)
for the project located at
(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 SIGNATURE4AAE REOUIRED
SIGNATURE
PRINT NAME T)ATF.
Business Name:
Address:
City/State/Zip:
Phone:
OFFICE USE ONLY:
St. Lucie County Building Department Property Owner's Affidavit
For Owner's of Property
Who Are Contracting To Have A Dwelling Constructed.
Name of Owners
Owners' Current Ac
Address of Property
01Pw �hti"'b- 4a
Legal Description 1I
i2J-
,---I I LLtI L4 #- 3
Parcel ID # Z+C)A — N q� -- QCX—) S
Name of Contractor: Vincent Montalto Const., dba Louran Builders, Inc.
1759 SW Biltmore Street PSL,_FL 34984
Contractor License No. State of FL RR-0067632 St. Lucie Co. 18739
We (I) affirm that, we (I) own the property and have contracted with, and fully
authorize the above contractor to apply for and obtain all required Building
Permit(s).
VSignature of Owner
P yoo a 3 /) 9
Signature of Owner
Sworn and Subscribed before me this l 2—day of % -A84?
The above is ( ) personally known to me or R— fias produ ed drivers' license
as identification. Number f /oo i/ ? 9 L/V66 Exp. Date 1,� �--6 �
(seal) G
ry Public Signature
State of County of
SUSAN OWEILL
No" Public - State of Flodda
MOCmrtn 010P E*m Oct T. 2001
Oaeuni M 0 OD 2d 33