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HomeMy WebLinkAboutSUB CONTRACTOR AGREEMENT,;Pro nollm, IBUILDINGFEW&T, SCANNED WAGREEMENT BY St. Lucie County ,OCTOBER G8 ,�— OKI ASHBURNPrinttYnme ! RRMtMAME, COCEN1YcERTIFICATIONNUMBER'.�" -_Hg '§40-10ARgURK a PrF©r,ct[ott�u trarari�:¢`ti ..rG� .4.;cA L�,T. -x. � 5.y n., � ^.T> ;, 2._ ✓.._. .�+-s, _DESIGNE ENGINEER;. "' NotRpR!"table NfQRTGAGE'COMPANY: _NoxA4 ' icabCe; ^ Name. uY w„ Rtfdress _ _ Address i- City Staie.. =_'M State ZCp - Phone__ - FEE SINIPJE TALE HOLDER: :Not ApplicableOIyDING CQtI(IPANY_; _ NotAppticable ,Addess.. _--,-- ___._ _r Address. _ , Ctty"s _ Phoned' - OWN Ea/CONTRASTORAFFiDVIT "Applicattia lshere6ymadetaabtai�raperm�ttodothe,worfrandln_stalla on;asigdcated' t eertdyttwt nn �nrorkor mstalfation has commeqceifpriorto the Issuance ofm permit _Slgnatureof0�vner/,_ _.,[WntractorasAgeht%rOwner Slgnatureof.forivactor� enseTiolder. STAiE OFFLORiDA SPATE OFllQRIQl1: COUNT,VGF Thergomgmstrumentwasa..cknoWCedged6eforertfe Tfieforgoirg strumerit.wasacknowteilgedbefote.me' tfiCS`'�3i day of .`o �`rC _ 2Q�9 by tFiis J�,eay df C=MR hO� 465 . _..-. Name of person fimmng;tatemeM N„ame'of pe�soa mating sfatemetft perspnally((noWl}, OR PmducedidentiHgt�on Personatfy,"w0-% n 7c ORProdaceiltde uflcaeton' ... Typeaf�depgRcafidn ., ;ypeofltJentificattan produced' � Orgduced_ - -: Pu_b. ltc'�S. t`ate f �StcCterryalJmP-pA�y5da1�Ghw3boR�ui012�2Ga2 reof_Nataaory21l_t,e. State f b2 P3ue0 5_-,R -fa_ fr r Nf3ofltein- yJWAbsfsh�b'Sutamre,_'u-,•t[: Cti�mEnraritisusrieonofNNoota--ry_' ?►a�a► na — a bdyCarroit�ssto4GG2 1-3 REVIEYVS? ZONING SUI!ERVISOR l?LANS VEGETATION 'SEAJl1RTLE MANCaROVE 1-._ _;ERONj'. GOTINTER, itEV1EW REVIEW REVIEW REVIEtN' __ REVIEW _ i..yREVtEW` _ -- _.. ➢ATE - v ➢ATE__ - � ; eYa PLANNING & DEVELOPMENT SERVICES Building & Code Compliance Division Burt T RECEIVED SUB -COI TRACT" A EEMENT O C T 2 2 2019 St. Lucie Count ST. Lucie County, Permitting LILLEY AIR CONDITIONING INC./KEITH LILLEY have agreed to be (Company Name/Individual Name) the MECHANICAL Sub -contractor for JENNINGS MOBILE HOME SET UP (Primary Con or)- -- For the project located at 1433-210-0003-000-9 (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, the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the I filing of a Change of Sub-contrai for notice. 47 .CONTRACTOR SIGNAT (Qualifier) ! 'I hnma 5 6. S-knn i t s PRINT NAME COUNTY CERTIFICATION NUMBER State of Florida, County of DOI The foregoing instrument was signed before me this _0day of ( r 20 1 by T �fyl:/ L9 "1. S0 who is personally (mown _or has produced a a ' entification. STAMP ature of Notary P011c Print Name of Notary -Public j YAW State of Florida urn ion GG 213502 /2022 Revised 11/162016 VA1 �I eyi7t: , 9- L I leu PRINT NAME C-kC0S-7 196 COUNTY CERTIFICATIONNUMBER State of Florida, County of 1 6 1 K The foregoing Instrument was sirnrd�ihor .o,na 'hi. r�r'i-s_ day of 20_e _ �111. who is ersonafiy known or has produced a as identification. STAMP giguntu—m-2-IN�66y Public _coil Ah Print Name of Notary Public R Notary PuMk Salts cf FloddsMyJIB A GG 2563V ' PERMIT # I I I ISSUE DATE i PLANNING & DEVELOPMENT SERVICES Building & Code Compliance Division :RECEIVED WELDING PERMIT SUB -CONTRACTOR AGREEMENT CT 2 2 2019 SCANNEDST. LCounty, BY tY, Permitting St. Lucie Count, LILLEY AIR CONDITIONING INC./ JARED GIBSON have agreed to be (Company Name/Individual Name) the ELECTRICAL Sub -contractor for JENNINGS MOBILE HOME SETUP (Type of Trade) -- - ! (Pnm`ary Con for) — - — -- — For the project located at 1433-210-0003-000-9 or Property Tax ID #) It is understood that, if there is a j y change of status regarding our participation with the above mentioned project, the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the filing of a Change of Sub -contractor notice. I ' y CONTRACTOR SIGNA RE (Qualifier) ,+ `�h�vn0.s �l • �-ev�v� Jtv�a S PRINT NAME COUNTY CERTIFICATION NUMBER -State of Florida, County -of _ 1 is _ T('heer,foregoing )instrument was sig�ne�d before me this � V day of Y who is personally (mown STAMP e of Notary PUbTCJLk)U PILAU 31Qu j Print Name of Notary Public •ourrSN Notary Public State Sheri J Ashbum 7� 1s Mi Commission GC @or w, 616ims 05/02/2022 Revised 11/162016 (L Ar ONTRACTOR SIGNATURE (QualiSer) QWrU " i - l li dl PRINT NAME GC 13004997\ COUNTY CERTIFICATION NUMBER State of Florida, County or Pb1 K The foregoing instrument was signed before me this y-gay of r L1 UU 20 1 by e - K. 15&6Abr old who is sonally Imo _or has produced a identities on. STAMP Signature of Notary Public