HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENTI
COUNTY
1, 0 R I D A
L
St. Lucie County Contractor Certification Number:
State of Florida Certification Number (if appijcabtcy CPVC(17�14_ILAI
ra Ctrk\ ArSL +ms n c have agreed to be
(Company NameiIndividual Name).
A�C .. GOY'VA sub -contractor for
(Type of Trade) (Primary Contractor)
for the project located at -33) 9 0(a Vr4e RX [ff� LV 1 -:4- V. ed, 1FJ v-1 qr)
(Project_ _Strc�t' A&ess orProperty Tax ID #) 11
It is understood that, if there is any change of status regarding our participation ith the
i' above mentioned project, I will >imrnediately advise the Building and Zoning De artmei
of St. Lucio'County by personally filing a Change of Contractor notice.. (Form: S CCDV
No. 004-00)
BUSINES.S QUALIFIER (Name of the individual shown on the Contractor's
ORIGINALSIGNATURES ARE REQUIRED
NA
)bqAivi u) VXJqnox
GPRIINT N&ME
Business Name: Gff�cl \ N
Address: Waal+z
f— lei
CitylStatelZip-
Pbone: --D I - W03 - i 9CO email:
USE ONLY;
E
~_ PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE COMPLIANCE DIVISION
m
BUILDING PERMIT
SUB -CONTRACTOR SUMMARY
lso"5 knp )P k Tom(. �%LVL�r-c' will be using the following sub -contractors for the
(Company/Individual Name) f
project located at ,�)t Q
(StreLq address or ffronerty 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
I C,
(,C 1,3005� 5�
Plumbing
W) , i
-N lc 5L� a 1
HVAC/
Ce nka 1 , r S i4c hn 1 Y)c
C P-r. 05 gig
Mechanical
Roofing
Gas
i
II PERMIT
ivuMBER: I I ISSUE DATE: 1
11
PERMIT # I ISSUE DATE
I '
PLANNING & DEVELOPMENT SERVICES
` Building & Code Compliance Division
` BUILDING PERMIT
_- SUB -CONTRACTOR AGREEMENT
i
St. I acie County Contractor Certification Number:
Stat of Florida Certification Number (If applicable): J. -c /300 Sq,_,r
have agreed to be the,
,E.0 Ec T21 C. Gc'' /NC. g ,
(Company ame/Individual Name)
49-c 7-/Z/ cq L Sub -contractor for
(Type of Trade) (Primary Contractor)
of the project located at �3 Or Lp1 -E-i ec�ce ��l
p � /
F -
(Project Street Addiess or Property Tax ID #)
It % understood that, if there is any change of status regarding our participation with the above mentioned
pr ect, I will immediately advise the Building and Zoning Department of St. Lucie County by filing a
Ch, Lnge of Sub -contractor notice. (Form: SLCCDV (No. 004-00)
SINESS QUALIFIER (Name of the Individual shown on the Contractor's License)
ARIZED SIGNATURES ARE REQUIRED
less Name: //1/F/n/ T��� T�2lC �o /Ne .
ess:
State/Zip:
e: Teo l - lob os 19cV email: //YiiNi ry f ee-cTe/C co�E[1 sa uT�Y • Nb' '
t fF.e�i •� 1N�/TE . 3� poi
4ATffE rJPRINT N M ATE
TE OF FLORIDAVOt'iL bCOUNTY OF e/ "
:FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS DAY O ` , 201'
WHO IS PERSONALLY KNOWN OR HAS
AS IDENTIFICATION.
c
V-1-71 V V [ ` wlyw
TURE OF NOTARY PUBLIC
IS: 12/16/2013
PRINT NAME OF NOTARY
(STAMP)
DAVID M. ANDERSDN
Notary Public - State of Florida
My Comm. Expires Mar 25, 2016
�''n';ovc��o-A�, Commission # EE 182599
OUT-., latleri It -
�COUNTY
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