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HomeMy WebLinkAboutSUB-CONSTRUCTION AGREEMENTPERMIT # By I ISSUE DATE J& PLANNING & DEVELOPMENT SERVICES Building &, Code Compliance Division St. Lucie County Contractor Certification Number: State of Florida Certification Number (If applicable): Company Name/Individual Name) 0i n (Type of Trade) PERMIT R AGREEMENT IN have agreed to be the for--[ ri,4.r,dk ej (Primary Contractor) For the project located at 15c--x4 Ib LIN (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 project, I will immediately advise the Building and Change of Sub -contractor notice. (Form: SLCCDV BUSINESS QUALIFIER (Name of the Department of St. Lucie County by filing a 004-00) shown on the Contractor's License) NOTARIZED SIGNATURES ARE RE RED Business Name: ` 3 M S o b (1 I Address: ?J City/State/Zip: ', nC 1,t�LL4 rr Phone, ` 0-7— " t s ! —q (� �5/ email: C-YI (P �� /� o (9nLkid 3-4- (Lt SIGNATURE RIIN NAME DATE P STATE OF FLORIDA, COUNTY OF �Vv THEFOREGOINGINSTRUMENT WAS SIGNED BEFORE ME THIS I DAY OF WIV'` , 20_L4 BY I rlfXY S re) 49- WHO IS PERSONALLY KNOWN OR HAS SLCPDS: 12/16/2013 AS IDENTIFICATION. (STAMP) NAME OF NOTARY PUBLIC MIMS ARMTROND E NANCY MY COMMISS10N E 059852�'PQ: EXPIRES Jpnuary 30,2015n`, &0153 r1oddallofarySarvice.cam PERMIT # ISSUE DATE PLANNING & DEVELOPMENT SERVICES Building & Code Compliance Division St. Lucie County Contractor Certification Number: State of Florida Certification Number (It applicable): ao (Company Napne,(inuividual Name) (Type of Trade) For the project located at PERMIT R AGREEMENT ` �/ U Sub -contractor for l Y `orna-s Y`i I (Primary Contractor) z L (Project Street Address or Property Tax ID #) 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 NOTARIZED SIGNATU ES AR[[4'at_ E REQUIRED HEQUIRED Business Name: q CA, R O Y' Address: City/State/Zip Phone: -i'11(0e s- l0 Ll,a� p� shown on the Contractor's License) ■� ■ ISI ATURE NAME DATE STATE OF FLORIDA, COUNTY OF THE FORREEG�O,I,N�GINSTRUMENT WAS SIGNED BEFORE ME THIS IL DAY OF -0 (( BY I �(�CV j j� I V I.t �( YUC( WHO IS PERSONALLY KNOWN ��ORHAS 7PRO CED n 0, U"- SIGNA URE OUbTARY PUBLIC SLCPDS: 12/16/2013 AS IDENTIFICATION. (STAMP) NAME OF NOTARY PUBLIC i NANCY MIMS ARMSTRONG MY COMMISSION # EE059652 EXPIRES January 30, 2015 Flo ridallotaryservice.com PL. "`THING & DEVELOPMENT S7-' VICES _3uilding & Code Compliance L _._ _sion BUILDING PERMIT SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: a O State of Florida Certification Number (If applicable): n— I have agreed to be the (Company Name/Individual Name) i t el 41 r L,�_ j sub -contractor for (Type of Trade) for the project located at (Primary Contractor) _02 Co %< )/es (Project Street Address or Property Tax ID #) Apk 1 7.2w L ST. LUCIE r 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 ofthe Individual shown on the Contractor's License) NOTARIZED SIGNATURES ARE REQUIRED Business Name: L Address: City/State/Zip: Eb Si!r L��r ri Phone: 3 7 U L( X-5 7 email: o% U- S'/S'£r ,� 1 C 0, I SI ATURE PRINT NAME DA • i STATE OF FLORIDA, COUNTY OF THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS , DAY OF 920 BY WHO IS PERSONALLY KNOWN OR HAS PRODUCED AS IDENTIFICATION. (STAMP) SIGNATURE OF NOTARY PUBLIC ,�j� : PRINT NAME OF NOTARY PUBLIC OFFICE USE ONLY: -_n PLANNING & DEVELOPMENT SERVICES DIVISION BUILDING & CODE REGULATIONS DMSION 2300 Virginia Ave Fort Pierce, FL 34982 BUILDING PERMIT SUB; CONTRACTOR SUMMARY i '/\O►'�'ICLS rcc_n{ will be using the following sub -contractors for the (Company/Individual Name) ^^�� project located at -5DCCp -� S kJ (Street address or Property Tax ID #) It is understood that if there is any change of status regarding the participation of any of the sub -contractors I 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 LAw i Plumbing t HVAC/ S2U91 A_0YVJO -7 / Mechanical ID S Roofing Gas OFFICE USE ONLY: PERMIT � � ISSUE DATE: NUMBER: C56-0 0 ,