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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- > 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