HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENT$ 08.23 0
SCANNED
BY
St. ,Lude county
I
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peRtu�R � •- -
PLANNING & AEVELoPWNII SIM11111
Building & Code COMPH'Ince Division
gU�,b)[�iG PE1tMiT
BU&CONIVACTOR AGREEMWT
i
i D n have agreed to be
�V1`t
(Co NmjW1ndividua1Neme+)
sub -contractor for contsa�r�
the _ - - tPrimnry
For the project located at � ` - [ ��----
(project 5tre Address or Prope Tax ID #)
It is understood that, if there is my change of statue regarding our pamCipatiaai with the above montioned
,� the auildislg and Cade Regulenon pivisian of St. Lucia County will be advised pcttsu�tlt to the
Prof ,
filing of a Cbange of sub -contractor notice.
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GOUNTv rHall CATION
COUNTY l6 —
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State ofPb Oa� Comb' forasorn iattrument vrat signed ye me tb�a der
ThR i regolag t umtot woe etp netc eeyae tbte day of
by 0n pne prodmtA a —
wba aao 11Y tmown
who is p.riwosiF/ tmowP
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print ame aPNozY Pu6na
Print PQeroe of Notayy PUEI
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SHERRI FEHLMAN
V
Revised 1 110°14
SHERRI FEHL"
2otPa
�
Commission # GG 187160
�FpY PUg��
•. ,, °
# GG 187160
M"'."'w
Expires March 14, 2022
r�
Commisskn
Expires Marcl►14,
sondes Thm Budget Notary seM""
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s
yrs of F�,o
4
BondedThm�etNotary
i
•
&RMIT # I ISSUE DATE
l _ PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
r BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
I, ba
'o Z_ "li
�oa lS
1, (C m ny Name/individual
the � /q%
(Type of Trade)
44
I 11 t d at
/)'/
have agreed to be
Sub -contractor for Z q ue_-�
(Primary Contractor)
For �he project oca e
i (Project Street Address or Property Tax ID #)
II
It is understood that, if there is any change of status regarding our participation with the above mentioned
e Regulation Division of St. Lucie County will be advised pursuant to the
Pro ct, the Building and Cod
fili 'lR of a Change of Sub -contractor notice.
CO TRA TO SIG URE (Qualifier)
D
P NT NAME
C I NTY CERTIFICATIONNMBER��.
St to of Florida, County of
i
T e regoing instruumen was si before me this day of
I � /
20T by
w io is personally kno`vn�i r has produced a
�i _'y —.0", &, STAMP
Of
rint Name of Notary Public
<~ � SKERRI FEN4�N
Revised I I/i6/2016 ,�;.Lt.vo comm►sr0n#GG'187160
" ExPltes Match 14, 2022
Q,�� ����pp8t1n1Ld
i i� I NTEOf C1•C
toz--l'
__4 SUB -CONTRACTOR SIGNATURE (Qualifier)
i �Zd
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of�&�Lt_t
The fo egoing instrument was signed before me this day of ne
, 20 by " ' �
who is personally known has produced a
5�as' entif, tion. A
Notary
Print Name of Notary Public
ttgY Pf/g�� SIiERRI FEHLMAW
o .+ •., o
a . Commission # GG 18716
* * Expires March 14.2022
Nj9rFOF fop?O� gadedTMu Bod6et Notary Services
AMP
i
PLANNING & DEVELOPMENTREGULATEIONSID VISIDON ISION
BUILDING & CODE
2300 Virginia Ave
,_.. Fort Pierce, FL 34982
BUILDING PERMIT
r SUB -CONTRACTOR SUMMARY
f will be using the following sub -contractors for the
((�ompany/Individual Namme)
p� oject located at �X �� A
E(Street address or Property Tax ID #)
is understood that if there is any change of status regarding the participation of any of the sub -contractors
fisted below, I will immediately advise the Building and Zoning Department of St. Lucie County.
St. Lucie County/
Trade Name of Company/Contractor State of Florida
License Number
Ele ctrica� CC%2oo d /� 7�
�- 910/
"
Plumbing
HVAC/
Mechanical
Roofing
Gas
PERMIT
NUMBER:
ISSUE DATE:
FIZZ