HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENTPERMIT # r I ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
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BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
SOANNED
BY
St Lu le Codylty
have agreed to be
` CompanynName/Individual Name) W
�qIthe Q I IU Sub;contractor for pt,►�g (e L IL
(Type of Tra ! (Primary Contractor)
For the project located at 1-6I06 GookvWl:
(Project Street Address or Property Tax ID #)
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It is understood that, if there is any change of status Iegarding 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.
tAftRACTOR SIGNATURE (Qualifier)
S NTRA O SIGNATURE (Qualifier)
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PRINT NAME k
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COUNTY CERTIFICATION/NUMBER
COUNTY CERTIFICATION NUMBER
State of Florida, County of
State of Florida, County of &,
The foregoing instrument was signed befhrecuthis of
The foregoing instrument was signed before
this day
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rl Name of Notary Public
Revised 11/16/2016
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PERMIT# 1803-0560 ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
(Company Name/Individual Name)
the ELECTRICAL
(Type of Trade)
For the project located at 13185 S INDIAN RIVER DR.
(Project Street Address or Proper
have agreed to be
for SOUTH FLORIDA SELECT HOMES
(Primary Contractor)
Tax ID #)
It is understood that, if there is any change of status regarding our participation with the above mentioned
I
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.
(Qualifier)
PRINT NAME
�C C- 0SA7, 6'c
COUNTY CERTIFICATION NUMBER
State of Florida, County of ISIC tild-111
The foregoing instrument was signed
�iti+.•- , 20d by 1ST'
wh i erson�ally known r has I
as identification.
Punt Name of Notar
Revised 11/16/2016
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S RE (Qua ' r)
JAMES SENNELL0
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PRINT NAME
EC13002240
COUNTY CERTIFICATION NUMBER
State of Florida, County of BROWARD
liteay of The foregoing instrument was signed before me this 28 day of
JUNE ,20byJAMES SENNELLO
a ^ `C'' who is personally (mown _or has produced a PERSONNat Y KNOWN�- ! u
zins
�a ui ac as i e tification. N W C_1 x O
a a E STAMP ` STAMP
o oApRureAf r4otary Public
O T
KRYSTAL LINDSEY
;o`.•' • ° Print Name of Notary Public
`o� •' S.�;o' ; S '1 °�e% KRYSTAL LINDSEY
Notary Public State of Florida zi
S My Comm. Expires Mar 1, 2019
•�.,�o�l�o�:� ommission # FF 174600
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PERMIT# %p�� 3 ^D�.�r� ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
i = Building & Code Compliance Division
Apollo Air Conditioning
(Company Name/Individual Name)
the HVAC
(Type of Trade)
For the project located at
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
(Project Street Address or
have agreed to be
for for S. FL Select Homes
(Primary Contractor)
Tax ID #)
It is understood that, if there is any change of status r garding 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.
Gq iTRACTOR &W&ATURE (Qualifier)
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PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of_�4_1 _(_%6 Q-
The foregoing instrument was signed before me this � day of
' 2oAby
o
.O N cn
wh ' personal] avow or has produced
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z o �
a
as iden � on.
CL c, K O
Signature of Notary is
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>, E E
fee aN
Print Name of Notary Public
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ea
50`�
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Revised 11/16/2016
ONTRACTOR ATU (Qualifier)
PST NAME
11
COUNTY CERTIFICATION NUMBER
State of Florida, County of
The foregoing instrument was signed before me this day of
20A by -
who is personally (mown or has produced a
as
of
yWa
Print Name of Notary Public
STAMP
GINA FLORI
Notary Public - State of Florida
Commission # GG 195948
My Comm. Expires Mar 13, 2022
ed through National Notary Assn,
PERMIT # / KO3 F 0 c ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
A ille / e 14e A0nt-4-1,-, ��� ,f�lO have agreed to be
(Company Na e/Individual Name)
the ( Sub; contractor for �O�fltlfif 1C� —<e `(I-ITI 11C11Y
(Type of Trade) Q- (Primary Contractor)
For the project located at l� l� , �i' f 1(G ✓1 1 c�(�,Uj�JP,/�
(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, the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the
filing of a Change of Sub -contractor notice.
CO CTOR S N (Qualifier)
LI�L *-6 a �LI-64J
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of 0k /c' L 0-1 a
�W
The foregoing instrument was signed before me this 7-1 day of
20 kby )&YjeL� I ��
who is personally (mown or has produced a
as identification.
Signature of Notary Public
Print Name of Notary Public
7
Revised 11/16/2016
SUB -CONTRACTOR SIGNATURE (Qualifier)
_<4 my e.! �y�� _
PRINT NAME
cc IS
COUNTY CERTIFICATION NUMBER
State of Florida, County of !6 rC V
The fooAregoing, instrument was signed before me this 62 V day of
20 19 by AveA
who is personally (mown or has produced a
M��
STAMP STAMP
Signature of otary Public
IW°
Mn'cor�ll�ss°lo�� 9340
Print Name of Notary Public EXPIRES: Decem!>c►14, 2019
�#"DFF�V ftAhdThtu8U*tN*ryS11kn
PERMIT # 1 ISSU1 `
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PLANNING & DEVELOPMENT SERVICES
Building & IC ode Compliance DivisionESTLude�jCnty
EIVC[
_-- - - -- BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT 2 2019
, Permitting
. I
i
WC010/� have agreed to be
(pany Name/Individual Name) �Q
the
C/�% �} S Ib-contractor for AMA. it �al%(�� ZPiljUlcoO
(Type of Trade) (Primary Contractor)
For the project located at jes'ls�l� ,�'jegC
(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, the Building and Code Regulation Division�of St. Lucie County will be advised pursuant to the
fill g of a Change of Sub -contractor notice.
SIGNATURE (Qualifier)
I
rnu� a i�euvi>r i
I
it
COUNTY CERTIFICATION NUMBER
`��±31 1t State of Florida, County o j
I
TJ.forrng instrument was signed before me this Aday of
20_, by Ae1�k \ ly\eh
who is tz,,..
ally (mown or has produced a � l
as iden
Sig re of 1Nulary Public
C—,Yvk
i/� �( l� l o h "�
Print Name of Notary Public
Revised 11/16/2016
Notary FuiblIC'State of Florida
Commission # GG 211245
My Comm. Expires Apr 25, 2022
COUNTY CERTIFICATION NUMBER
State of Florida, County of )C�ce'
The foregoing instrument was signed
before methiso!ti day of
2014, by W%d�l�d- hn
who Is perso ally (mown or has produced a _ELVA1
as
Of
STAMP
$61
Rebekah Hoy
NOTARY PUBLIC
STATE OF FLORIDA
Comm# GG294610
Expires 2/17/2023
'I
PLANNING & DEVELOPMENT SERVICES
. t-
BUILDING & ZONING DIVISION RECEIVED
® 2300 VIRGINIA AVE
a s
_ -- - - FORT PIERCE, FL 34982 J U L 2 5 2019
(772) 462-1553 FAX 462-1578
ST. Lucie County, Permitting
CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMT
PLEASE SELECT ONE OF THE FOLLOWING:
CHANGE'OF CONTRACTOR — Change of Contractor is to be signed and notarized by the property owner,
and the new contractor of record for the current permit. A new permit application must also be completed with new
contractor information and signature. A new Notice of Commencement must be filed in the new contractor's name
for job values greater than $2,500 ($7,500 if A/C Change -out). A recorded copy must be submitted prior to
c cin any work. There is a $50:00 fee for th'e Change of Contractor.
RANGE OF SUBCONTRACTOR-- Subcontractor changes are to be completed by the general -contractor.
The new subcontractor must fill out a Subcontractor Agreement Form. There is a $50.00 fee for the Change of Sub-;
Contractor.
CANCELLATION OF PERMIT The cancellation of a permit is acceptable only if no work has been done.
Cancellation of permit is to be sighed and notarized by both the owner and qualifier of record. There is no fee for
cancellation of the permit.
Date:`
Site Address: �� f
Original GC, subcontractor or owner/builder
Permit Number. rl�'
License SLC License
s State License0/S SLC License
New GC, subcontractor ,
Reason for Cancellation
The undersigned does hereby agreeto'indemnify and hold harmless St Lucie County, its officers, agents and employees from all
costs, fees or damages arising from any and all claims, -of action, for any reason, which may arise as a result -of this change of
contrac r/subc tra for or Nation of.permit. A permit can t e cane 1 work k has been performed.
Sf 'NATURE OF OW E (or owner den) SI GEVE/RAI CONTRACTOR (orne%v GC, as applicable)
PRINT NAME: i^ PRINT NAVIF. 4�/L '1 0'! F✓`l� rr G�
State of Florida, County of St. Lucie County
The Following instrument was acknowledged before me this
�� day of- &4 _20_K_. by WfcbA- -
_l*t who is personally known to me
or who has produced as ID. A&Au---j 6jzc 1^1
Signature of Natary Date
Revised 04
ANTHONY A�AN ADAMS
State of Florida -Notary Public
-• �= Commission tt GG 233619
a•:
My Commission Expires
June 28. 2022
State of Florida. County of St Lucie County
following myytrrumen[ vas acknowledged �efore�m�,ethis
day of b/E. t! % it P.,
who. is -personally known to
me or wfio has produced asZl*
Signs re Olt
/
>�1 U.f� Crhest Clayton Yates
Commission # GG143474
5�c - .
ExA ires: September 17, 2021
'f-'�%i;¢;�;���'�� So ed thru Aaron Notary
Ot�\
PERMIT # IS,
03- G � j „1' ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building, & Code Compliance DivisionE
ECEiVE-D
BUILDING PERMIT U N 2 4 Z019
SUB -CONTRACTOR AGREEMENT
e County, Permitting
have agreed to be
(Company Name/Individual Name)
the � e C:. _ Sub -contractor for -<SW`v1h �i ft % IBC ws (C)(' ?
(Type of Trade) I (Primary Contractor)
For the project located at
(Project Street Address it Property Tax ID #)
It is understood that, if there is any change of status regarding our participation with the above mentioned
i
project, the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the
of Sub -contractor notice.
COUNTY CERTIFIC,iTION NUMBER
State of Florida, County of
The foregoing instrument was signed before me this day of
u 2oja, by � je Y 1�`1
who is pept�o} ally known _or has produced a
S O\ ilftOR.31QNATURE(Qualifier
PP IVIF NAME
�t3�v-Iq% 5
COUNTY CERTIFICATION NUMBER
State of Florida, County of
The foregoing instrument was signed before me this day of
n
jtx�u , 20, by a
who is personally known r has produced a
as id t' is lion. as identification.
S`fAhiP %itf t ��.e. G•J� L / f 7'TAMP
gn ure of Notary Public Sig�y lure of Notary Pub C'
Frio N'. ue of Notary Public Print Name of Notary Public
g" NY °u¢ : EMILIO GIL
•,; RAVINAMICNELLE BARKLEY
Notary Public . State of Florida ¢� Commission # GG 114094
Commission # GG 211245
My Comm. Expires Apr 25, 2022 Expires February 3,2022
sandedit 7my Fain hwurince 00 95.7019
Revised 11116.CW6