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HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENT & SUMMARY� J PLANNING AND DEVELOPMENT SERVICES DEPARTMENT Building and Code Regulations Division project located at It is understood that if there is any chang listed below, I will immediately advise the BUILDING PERMIT :ONTRACTOR SUMMARY will be using the following sub -contractors for the AMW I address or Property Tax ID #) status regarding the participation of any of the sub -contractors [ding and Zoning Department of St. Lucie County. Trade I Name of Company/Contractor I St. Lucie County/ State of Florida License Number Electrical Comet Electrical 013 i6q 1�'Wmo Plumbing Aqua Demenisions 18628 CFC057526 HVAC/ Mechanical Delair Heating and AC 27191 CAC032448 Roofing Sunshine RoOng 25387 ICCC 1327796 Gas I I I I I OFFICE USi+ys—nNLY PERMIT ISSUE DATE: NUMBER: it Revised 07/29/2014 I � 11 I I PERMIT # I (� ISSUE DATE & DEVELOPMENT SERVICES & Code Compliance Division Mark Lurtz/Comet Electric & Equipment, LL, (Company Name/Individual Name) the Electrical (Type of.Trade) For the project located at (Project Street It is understood that, if there is any change of BUILDING PERMIT INTRACTOR AGREEMENT have agreed to be Sub -contractor for Phoenix Companies (Primary Contractor) or Property Tax ID #) regarding our participation with the above mentioned project, the Building and Code Regulation Divilsion of St. Lucie County will be advised pursuant to the filing of a Change of Sub -contractor notice. CONTRACTOR SIGNATURE (Qualifier) iqIRV 1�Ail PRINT AME COUNTY CERTIFICATION NUy�L(t�/ State of Florida, County of The foregoing instrument was signed before me this L_#_ day of 00 Una"- 20M by V& who is personally known or has produced a as identification. STAMP ignature o otary Public f'�o11(�>�s oA)ZA Print Name ofltfotary Public e, yW vo Notary Public State of Florida _° �; Frances Donza < My Commission GG 092440 �oFao�`' Expires 07/27/2021 Revised 11 X. SIGNATURE (Qualifier) Mark Lurtz PRINT NAME 23169/EC13002784 COUNTY CERTIFICATION NUMBER State of Florida, County of Palm Beach The foregoing instrument was signed before me this day of . 20� by who is personally known _for has produced a STAMP PERMIT # ISSUE DATE PLANNING & DEVELOPMENT SERVICES & Code Compliance Division the (Type of Trade) Name) For the project located at 11--W a (Project Street It is understood that, if there is any change of project, the Building and Code Regulation filing of a Change of Sub -contractor notice. XCONTRACTOR SIGNATURE (Qualifier) PRINT NAME 0-5-0 IOvG5 COUNTY CERTIFICATION�BE�State of Florida, County of?'C he foregoing instrument was signed before me this day of 20 by A who is personally known _or has produced a BUILDING PERMIT )NTRACTOR AGREEMENT or as identification.�—y/7 <4412 //L M /J(J -01� STAMP Signature of Notary Public - U lvCi�.3 / Print Name of Notary Public �, Notary Public State of Florida Frances Donza My commission GG 092440 orwo� Expires 07/27/2021 Revised 11/16/2016 RECEsIV ID J UN 0 12017 BY: have agreed to be for flomes/1� (Primary Contractor) Tax ID #) regarding our participation with the above mentioned of St. Lucie County will be advised pursuant to the SUB CONT'RICTOR SIGNATURE (Qualifier) ' her•f- Lud la wt PRINT NAME 1� CITY CERTIFICATION NUMBER State of Florida, County of .Jt wc.i e The foregoing instrument was signed before me this 31sa y of 20_a, by �d1Xf t L J I lL F& who is personally known 'or has produced a as identification. C STAMP Signature of Notary Pub6c (Afird& r-- tC r h� - Print Name of Notary Public ;,►is�% RHONDA LAFFERTY 'c MY COMMISSION # GG058720 EXPIRFS January 08, 2021 PERMIT# I 10-5 U�cp I ISSUE DATE U0 vv V PLANNING & DEVELOPMENT SERVICES Builditig & Code Compliance Division (Company Name/Individual Name) it the t-U/A e. (Type of Trade) For the project located at �q'a'5 (Project Street Ad( It is understood that, if there is any change of project, the Building and Code Regulation Di filing of a Change of Sub -contractor notice. BUILDING PERMIT 1NTRACTOR AGREEMENT 6 6'0-1 -7AC-, have agreed to be Sub -contractor for ���^�c (Primary Contractor) or Property Tax ID #) regarding our participation with the above mentioned ion of St. Lucie County will be advised pursuant to CONTRACTOR SIGNATURE (Qualifier) I 414A) PRINT NAME /7 kJnqg5?C/,,a5 COUNTY CERTIFICATIONLNUMBEPA State of Florida, County o The foregoing instrument was signed before me this day of 241, by Qj4! ? who is personally known _or has produced a as identification. jW42 U i STAMP II Signature of Notary Public 1U S --awn Print Name of Notary Public Revised 11/16/2016 PRINT NAME () /119 COUNTY CERTIFICATION NU�M�B,E�R� State of Florida, County of5e ...y 4e— The foregoing instrument was signed before me this day of who is personally known ✓or has produced a i entification. , & 1 STAMP VA.AA Signature of Not ublic Print Name of Notary Public C"- -Ryl- AKr--Rs MY COMMISSION # FF998962 K; ne 05, 2020 EXP IA ES JUSerrice.com (407)398-0153 i PERMIT# ISSUE DATE PLANNINQ & DEVELOPMENT SERVICES Building & Code Compliance Division St. Lucie County Contractor Certification Number: State of Florida Certification Number (if applicable): Sunshine Roofing, LLC BUILDING PERMIT INTRACTOR AGREEMENT 7 C1327796 (Company Name/Individual Name) roofing Sub -contractor for (Type of Trade) For the project located at 3 d5 3��' have agreed to be the (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 Buildii g 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: PO Box 1083 City/State/zip: Palm City, FL 34991 Phone: 772-260-8195 email: sunshineroofingllc@gmail.com � 1 Jamie Cisco ZSIG ATURE PRINT NAME DATE ATE OF FLORIDA, COUNTY OF THE FOREGOI INSTRU ENT WAS SIGNED BEFORE ME THIS _Zy DAY OF , 204— ' I BY I WHO IS PERSONALLY KNOWN OR HAS PROD ED AS IDENTIFICATION. (STAMP) SIGNATURE OF NOTARY PALI =O Y p`B4^ Noli M6TC1V*MLFl®FN ARY PUBLIC Frances Donza SLCPDS: 08/06/2014 y c o My 6ommisslon GG 092440 9?of�o� Expires07/27/2021 - -