HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENTPERMIT# -�9)tD_ {� O� ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT SCANNUi
SUB -CONTRACTOR AGREEMENT By
St. Lucie County Contractor Certification Number:
State of Florida Certification Number (inapplicable):
have agreed to be the
Nam
Name)
u E d't a\ -) Sub -contractor for
(Type of Trade) (Primary Contractor)
For the project located at Li 5 -Z� Ui -51 G--
(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 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:
City/State/Zip:
Phone:
email:
SIGNATURE PRINT NAME DATE
STATE OF FLORIDA, COUNTY OF
TH%FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THISC. ) DAY OF , 20 (�^
BY ( I I ^ Wnv 10 rr,n1 CIvi.
PRODUCED - e ' a 0- �7y AS IDENTIFICATION.
(STAMP)
�NATURE PRINT NAME OF NOT RY PUBLASHAHNA IAir.
S�NOTA=YPUBLIC = ' « ma's Gi'AA4
Notar
SLCPDS: 08/06/2014 My oYPublic gl; •,
tom. C mm
'•249
'_ tWY Assn.
PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number:
State of Florida Certification Number (If applicable): CR��AQ
(Company Name/Individual Name)
Sub -contractor for
(Type of Trade
For the project located at
u v; 's /,,—C,—
(Primary Contractor)
Street Address or Property Tax ID #)
have 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 Individual shown on the Contractor's License)
NOTARIZED SIGNATURES ARE REQUIRED
Business Name:
Address:
City/State/Zip:
Phone:
email:
Er
SIGNATURE PRINT NAME DATE
STATE OF FLORIDA, COUNTY OF�n
E FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS DAY O , 20
BY WHO IS PERSONALLY KNOWN OR HAS
PRODUCED 1 5 aye•L� �! AS IDENTIFICATION.
SIGNATURE OF NOTA Y PUBLIC
SLCPDS: 08/06/2014
(STAMP)
PRINT NAME OF NOTARY PUBLIC
`2�S"i-�'•R'• . ".S' +I+.fiNA ING9AM
i
`4(-t�ly Yuolic -State of Florida
' =M C
Y omm. EHPires Dec 20, 2018
Commission # FF 177249
Bondrd through
e �Nationa', Notary Assn.
PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number:
State of Floridaification Number (If applicable):
�--C1,`y ,�� *, r--,
&,V✓
Com ny Na e/ dw„�d'�ialN �i
Sub -contractor for
Type of Trae)�
For the project located
(Primary Contractor)
or Property Tax ID #)
have 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 Individual shown on the Contractor's License)
NOTARIZED SIGNATURES ARE REQUIRED
Business Name:
Address:
City/State/Zip:
Phone: email:
SIGNATURE PRINT NAME DATE
STATE OF FLORIDA, COUNTY OF � -
E FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS �_� DAY OF
g�, WHO IS PERSONALLY KNOWN OR HAS
PRODUCED jYil4o�g �''� AS IDENTIFICATION.
SIGNATURE OF NOTARY PUBLIC
SLCPDS: 08/06/2014
(STAMP)
h
PRINT NAME OF NOT RY PUBLIC ..... LA°••?.HNA INGRAM
+ Notary Puhhc . State of Florida
=• :04.
�•: MY COMM Expires Dec 20, 2018
r, Commission !< FF 177244
n"' +
Bonded t,uough Nations; lolary Assn.
,�._ W
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
Building and Code Regulations Division
BUILDING PERMIT
SUB -CONTRACTOR SUMMARY
will be using the following sub -contractors for the
(Company/Individual Name)
G / <7
project located at 1 �% / �'�/ (/ ! $ % u -� . f 16 P-0
(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
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
Plumbing-
HVAC/
Mechanical
Roofing
Gas
PERMIT
NUMBER:
l bs—
ISSUE DATE:
11
Revised 07/29/2014