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HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENTSCANNED BY 8R, Lucie C®un$v PERMIT # ISSUE DATE CEl t'W ® AUG 2s PLANNING & DEVELOPMENT SERVICES Building & Code Compliance Division BUILDING PERMIT SUB -CONTRACTOR AGREEMENT St. ucie County Contractor Certification Number. _ 2015 (C15fihave agreed to be. the (�npany Name/Indiv" tal Name) 1 _ Q t Rea N I � n C� 1l, a Sub -contractor for (Type of '& j (Primary Contractor) For�the project located at (Project Street Address or Property Tax ID #) It isll'lunderstood that, if there is any change of status regarding our participation with the above mentioned proi,ect, I will immediately advise the Building and Zoning Department of St. Lucie County by filing a of Sub -contractor notice. (Form: SLCCDV (No. 004-00) BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License) NO ' 'ARIZED SIGNATURES ARE REQUIRED Busii °ess Name: Addr �Iss: / i City/ tate/Zip: �//�I'� email: kz�I Q51C,'1-t SIGN TURE RENT NAME / DATE STA 'E OF FLORIDA, COUNTY OF THE IIOREGOING I UMENT WAS SIGNED BEFORE ME THIS DAY OF , 2 . By I WHO IS PERSON ' FRANCES DONZA PROD;IJCED AS IDENTIFICATION. _+ . MY COMMISSION I FF 014070 EXPIRES: July 27, 2017 flF .ttd Bonded Thru P I' derwnters �'., �TURE OF NOTA PUBLIC PRINT NAME OF NOTARY PUBLIC SLCP CIS: 08/06/2014 . RECEIVED k, ,v 7 2015 PLANNING AND DEVELOPMENT SERVICES DEPARTMENT ® Building and Code Regulations Division BUILDING PERMIT SUB -CONTRACTOR SUMMARY i 1 will be using the following sub -contractors for the ( ompany/Indivi al Na e) % -moo - � rz�� p� oject located at (Street address or Property Tax ID #) I I is understood that if there is any change of status regarding the participation of any of the sub -contractors li ted below, I will immediately advise the Building and Zoning Department of St. Lucie County. i itSt. Lucie County/ Trade Name of Company/Contractor State of Florida j License Number Electrical _. 719(o Plumbing o7Gl o� i i HVAC/ Da1 Mechanical Roofing, i Gas i i I, Y E FFICE USE QNLV:; PERMIT 'NUMBER: -- � " ISSUE DATE: fvised 07/29/2014 ECER77D AUG 272015 PERMIT # I I ISSUE DATE PLANNING & DEVELOPMENT SERVICES Building & Code Compliance Division ... ...... .. -: -:. -, - BUILDING PERMIT SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: �?r( 19 ! to State Ib Florida Certification Number (Inapplicable): Ea 0 ®ID 3 r7l LQ s, have agreed to be the l (Company Name/individual Name) A-64r(C a ( Sub -contractor for (Type of Trade) (Primary Contract ) For he project located at _ j7 70�1- 6 " or� .17 111 (Project Street Address or Property Tax ID #) It is �nderstood that, if there is any change of status regarding our participation with the above mentioned I will immediately advise the Building and Zoning Department of St. Lucie County by filing a of Sub -contractor notice. (Form: SLCCDV (No. 004-00) VESS QUALIFIER' (Name ofthe Individual shown on the Contractor's License) tIZED SIGNATURES ARE REQUIRED Name: -be1-A4 C El2C4l_L«t S'�eCU(L!2 , �C• :/zip: 3 n rcQ EL :� '?6Ce 1.1113 email: (c)lj6LrljoeU6.,j cv d SIGNATURE PRINNT NAME DATE STA I OF FLORIDA, COUNTY OF _ t, A Y jl k.Jl L3 _, THE OR GOING INSTRU,IMENT WAS SIGNED BEFORE ME THIS 4 DAY OF , 20 II BY C _ WHO IS PERSONALLY KNOWN L--�OR HAS PR lRE%OF NOTARY PUBLIC 08/06/2014 AS IDENTIFICATION. ���Anule, �olb (STAMP) PRINT NAIWIE OF N TARY PUBLIC F�;_7z STEPHANIE RALLOCommission # FF 175017 :,; Expires November 9, 2018� pF F�°:�� Bonded Thm Tmy Fein Insurance BDD485-7019 G 0 12015 RECEIVED AUG 2 7 2015 s rL.A G& DEVtILOPMEINT ERVI., .,:NN IN .sanding CodO COm.1flaiteO, DIVI 10 BUILDINGPMMIT �DV' WCONT-RA"CTOR",AQRU- KNIMT Slhte-p . ........ ._We4g, feed:W be:10.1c jz U-41A 10 1 rOl gub-OffliOctorflor j " 1.-'/ Syr (P c liffild 6 uw-ofliadd)' 011ilkry-1 6� 44 forlhe Ord odt located ,:at 1— di � " P- , it.is- widamood -thAt, If tllwJ4 pyeh4lip of 'status;:.regar igg Or, ' lrmpoOow... - D ic i t�j advise ille.8ttilding and Zoning _eparWlbdt Above nientiou'dd pro immod'o y Oorm'KCCDV i - of�st.,,L.11cie,co,tlllt-ybylpersci.iiatl,-yfil*tig.6,011an pfCogtroctorliotic.e No: 0044.0) OW.GlNAl`.",WGNATURf,$, AREREQV" `31)OA) 1)L_L6_x 7 - 2'? -IS Sl PRINT NTAAIT-': DATL, — rin�! 21 m BNam e: t-L Addrf.ss: ."'sck'd sw �N -P. IkQ or 0 PERMIT# ISSUE DATE f RECEIVED At—1 'i 2015 PERMIT # I I ISSUE DATE PLANNING & DEVELOPMENT SERVICES Building & Code Compliance Division BUILDING PERMIT , SUB-CO\TRACTOR AGREEMENT �' a'� I C St. Lu ie County Contractor. Certification Number: pp CiState of Florida Certification Number Ira applicable): s e 1 A t a l(- o J(6'0 ' l- i2e1C0-AQV1 have agreed to be th (Company Name/Indiv' at Name) `�Gn� (C I Sub -contractor for rc14944 ype of Trade) , l (Primary Contr otor) For thl� roject located at II I1P G (Project Street Address or Property Tax ID #0) It is ut4derstood that, if there is any change of status regarding our participation with the above mentioned I will immediately advise the Building and Zoning Department of St. Lucie County by filing a 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 Susittes Name; -t4?-Af)A, Air Address l ® q City/Stale/Zip: (q11—d 7 _ Phone: -1 3.3 31G �� email: j&L e Ae I o Y. I RA 9-5; URE PIUNT NAME DAT STATE OF FLORIDA, COUNTY OF THE F{R G NG INS' I2U, EN VAS GNED FORE i•fE'PHIS DAY OFU , 20 BY ISO WHO IS PERSONALLY KNO«'N OR HAS III PRODUI ED AS IDENTIFICATION. (STAMP) SIGNATURE OF NOTARY PUBLIC PRINT NAME OF NOTARY PUBLIC SLCPD 08/06/2014 ,=Q.� Y •°� MIRINDA C. TURNER MY COMMISSION # FF 223790 EXPIRES: June 14 2019 q ; t° Bonc±ed Tfiru Not Public Underwriters