HomeMy WebLinkAboutSUBCONTRACTOR SUMMARY-AGREEMENTPLANNING & DEVELOPMENT SERVICES DIVISION
BUILDING & CODE REGULATIONS DIVISION
2300 Virginia Ave
Fort Pierce, FL 34982
BUILDING PERMIT SCANNED
SUB -CONTRACTOR SUMMARY BY
St. Lucie Count,
-will be using the following sub -contractors for the
(Company/Individual Name)
project located at /S K 6 - /.5 K K ->�)�' A/ ", Z-1D W)_/ &'Cler /,z
L
(Street address or Property T
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 Conlpany/Contractor7
t. ucle County/
Sta`le of Florida
License Number
Electrical
Ll F z e-C �—/z "'r-
13'�Vs-gsle'
Plumbing
HVAC/
Mechanical
Roofing
Gas
FL- C, 7—y 61gs
-7-doy ItClIfI34V 61'6�
C rC 1117- 61C2
F
PERMIT ISSUE DATE:
NUMBER: I I
PLANNING & DEVELOPARNT SERVICES 4- -44L
I -"ding & Code Co'mpliance Div: _n
6 CIS
St Lucie County Contractor Certffication Number:
State of Florida Certification Number (if applicable): e�, BY
BUILDING PERMIT
SUB�CONTRACTOR AGREEMENT
. I
11-4
(Company Name/Individual Name)
St . LOCIP U1 A), �
have agreed to be the
C e-- 7—K f'e--- A Z- sub -contractor for
Crype of Trade) (Primary Conftctor)
for the project located at 0 S bl ?V x1A tv
(Project Street Address or Property Tax ID
It is understood that, if there is any change of status regarding our parficipation with the above mentioned
project, I will immediately advise the Boding and.Zoning Department of St Lucie County by Ming a
I Change of Sub -contractor notice. (Form: SLCCDV (No. 004-00)
' i
WSINESS QUALIMR (Name ofthe Individual shown on the Contractor's License)
NOTARIZED SIGNATURES ARE REQUIRED
Business Name:
Address: 9k/ 4A-l'R_o
City/State/Zip: 01119A-T- ST- L_ L,; e- Ire IK�4-
Phone: email: AA-Z " /f d- 6-4 Z_ S a C/-,,-//, Ale— r
P�) E
PRINTNAmE
sTATEoFFLoRIDA,couNTYoF
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME TE[IS a�> DAY OF ;:� tyyN 9, 20 t�,
WHO IS PERSONALLY KNOWN — OR HAS PRODUCED Lb
S EIDENTIFICAT O�N.
S' T
I Ole
Q_ CS, y-, Y\
0 1"4013, -ties lle� 58761
IGNATURE OF N ARY PUBLIC So
PRINT NAME OF NO n 0 M0.
OFFICE USE ONLY:
\501;
PLANNING & DEVELOPMENT 8"VICES
3uilding & Code Compliance Ision &
BUILDING PERMIT
SUB�CONTRACTOR AGREEMENT SGANNEU
St. Lucie County Contractor Certification Number: C BY r)
State of Florida Certification Number (if appiicaie):
/Salsso hno
(Company Nameftdividual Name)
6VC1Y2Lq1S7
have agreed to be the
R)PI&I - sub -contractor for 1Y)II04eJ 60440�C
(Type of Trade) (Primary, contractor)
for the project locat . ed at16_R1_7T Ply 1P. V-S
(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 Depiartment of St. Lucie County by filing a
Change of Sub -contractor notice. (Form: SLCCDV (No. 004-00)
11USMSS QUALHUR (Name ofthe I . n z d iv'idual shown on the Contractor's License)
NOTARIZED SIGNATURES ARE REQUIRED
B u sinessName: 10fUlld
Address: ,wly
City/State/Zip: a.wcic
Phone: 22�- SW29-;2 email:
eA Wo AagS 0 0
4L
SIGNATUM P NTN DATE
STATE OF FLO REDA, COUNTY OxJz1_/
0
UJ un-
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L)
W
cc
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME TMSZJ DAY OF 20
Z? 1) Cc 1PI
BYQ64 104 t-0 WHO IS PERSONALLY KNOWN — OR EH[AS PR UCED dl-r -V-4 C
I V .
(STAW)
PRINT NABIE OF NOTARY PUBLIV,
,46% AUDREY&HUMPHREY
MMISSION # FF 174772
%C,01RES: Maych 6,2DI9
OFFICE USE ONLY: 11