HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENTl`
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PERMIT #���L��F� ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Lucie County Contractor Certification Number: a ` S IT-1
of Florida Certification Number (If applicable):
(Company Name/Individual Name)
(Type of Trade)
have agreed to be the
Sub -contractor for it I�A
(Primary Contractor)
the project located at _c)\3
(Project Street Address or Property Tax ID #)
understood that, if there is any change of status regarding our participation with the above mentioned
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)
QUALIFIER (Name of the Individual shown on the Contractor's License)
ARIZED SIGNATURES ARE REQUIRED
Name: t= S �"i_ O%' %\,�eA.Y C6 -
- yb J' az�z email:
/GI j9e. r�H-eA." '5_zlbA%a
IGNAITRE PRINT NAME DATE
STA E OF FLORIDA, COUNTY OF _rC1Ar�f t1
THEOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS DAY OF 20
CC1.a��c� .�
BY Ii��S�r�'� Q Al WHO IS PERSONALLY KNOWN L-----OR HAS
II
PRO I,IIUCED AS IDENTIFICATION.
(STAMP)
SIGNIITURE OF NOTARY PUBLIC PRINT NAME OF NOTARY PUBLIC
SLCPI S: 08/06/2014
STELLA M. HUNTER
Notary Public -State of Flcrida
Commission # FF 180552
�c;',o My Comm. Expires Jan 23, 2019
Bonded through National Notary Assn.
•b
i
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
Building and Code Regulations Division
BUILDING PERMIT
SUB -CONTRACTOR SUMMARY
't�1Ac� Q A\sY� will be using the following sub -contractors for the
(Company/Individual Name)
project located at
(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
3C 4
Plumbing
'Sb e
HVAC/
Mechanical
p�.v at
Roofing
Gas
OFFICE USE ONLY:'
PERMIT �p _ ISSUE DATE:
NUMBER:
Revised 07/29/2014
— — ••• yL • ui.vi i� LL.t� 1 aLiC V 'no
- Building & Code Compliance Mon
'
MM
p
- --_ - BUILDING PERMIT
NEW SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number:
State of Florida Certification Number 0faMicabie):
(Company Name/Individual Name) have agreed to be the
CN%� Sub -contractor for,��� .�
(Type of Trade)
(Primary Contractor)
For the project located at'��
(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) '
BY
QUALIMR (Name of the Individual shown on the Contractor's License)
= Name:
Sko `Zo'-C4 R . P
5y- V3�• 10�3 email:
e
PRINT NAME DATE
TE OF FLORIDA, COUNTY OF _' X\P% ' k N rN
FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS
DAY OF t(Z h.t , 20_\Ia
WHO IS PERSONALLY KNOWN t�OR HAS
AS IDENTIFICATION.
OF NOTARY PUBLIC PRINT NAME OF NOTARY PUBLIC
08/062014 -
(STAMP)
1 8"
;.�o s�•,, STELLA M. HUNTER
. Notary Public -State of Florida
Commission # FF
52
M,Q', My Comm. Expires Jan 23 2019
Bonded through National Notary Assn
PERMIT #
1.
ISSUE DAB- �r
r. >:-< PLANNING & DEVELOPMENT SERVICES
fi ,I��,:I-! Building & Code Compliance Division
O D
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number:
State of Florida Certification Number (If applicable):
- have agreed to be the
(Co any Name/individual Name)
%V wz_ Sub -contractor for _��t NA N-�I"3
(Type of Trade) (Primary Contractor)
For the project located at
(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: `_[ +�c�ge Q�S�CX� R-\ - `���•�'�
Phone: �1'"\a, - y�� -yey� email:
SIMNAWRE DATE
STATE OF FLORIDA, COUNTY OF '%'X\fN C" N N cN
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS &::�J DAY OF 20—\&
BY_ '(�S�t'�'� \ Pt1
WHO IS PERSONALLY KNOWN FOR HAS
PRODUCED AS IDENTIFICATION.
SIGNATURE OF NOTARY PUBLIC
SLCPDS: 08/06/2014
PRINT NAME OF NOTARY PUBLIC
MAYP6,10, STELLA M. HUNTER
* NO public - State of Florida
Commission # FF 180552
of «o?, My Comm. Expires Jan 23,
""" Bonded through 2019
9 Nationat Notary Assn
(STAMP)