HomeMy WebLinkAboutSUBCONTRACTOR AGREEMENTS - SUMMARYPERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
SCANNED
BY
St Lucie County
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie' County Contractor Certification Number:
State of FlorPa Certification Number (If applicable;.
Sub -contractor for
(Type of Trade)
For the project located at
Contractor)
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 Contract ' License)
NOTARIZED SIGNATURES ARE REQUIRED
Business Name:
Address:
City/State/Zip:
one: email:
L ETC_ �
SIGcP`RINTNAME N TUBE
STATE OF FLORIDA, COUNTY OF
I "L' II - l4
DATE
THE FOREGOING INSTR�7�q�NT WA SIGNED B
%%EFORE ME THIS DAY OF 20 I
BY L�� \ —1�1L� 9L WHO IS PERSONALLY KNOWN OR HAS
PRODUCED \DL2== AS IDENTIFICATION.
MP)
NIX
N I' RE * NOTARY PUBLIC PF ' &TNA E O NOTARY PUBLIC \1
SLCPDS:
ANGEIAM.HUFF
M1 COMWSSION 8 EE 083530
EXPIRES: April 12, 2015
Bawad That Notary public undarvmtam
PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT SCANNED
SUB -CONTRACTOR AGREEMENT BY
St. Lucie County Contractor Certification Number: St Lucie County
State of Florida Certification Number (if applicable):
have agreed to be the
(Co parry Name/Indivi ual Name) '
n ,� Sub -contractor fo ,U
(Type of Trade) `C G L (P unary Contrac or)
For the project located at 3 P /'? t, kf (4 � R -r 10d..-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:
C-ty/State/Zip:
P one:
email:
aZ
SIGNA URE PRINT NAME DA
STATE OF FLORIDA, COUNTY OF [ g �r)�
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS DAY OF 20_
WHO IS PERSONALLY KNOMW ORHAS
or
m
u tfo / ,A 1 /,1! S it .• / t•
SLCPDS:12/16/2013
0
PLANNING & DEVELOPMENT SERVICES DIVISION
. BUILDING & CODE REGULATIONS DMSION
2300 Virginia Ave
Fort Pierce, FL 34982
BUILDING PERMIT SCANNED
BY
SUB -CONTRACTOR SUMMARY St Luce County
�o_rk_p_ will be using the following sub -contractors for the
(Company/lndividual 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
%%
Plumbing
Mechanical
Roofing
Gas
OFFICEfUSE
PERMIT ISSUE DATE:
NUMBER: