HomeMy WebLinkAboutSUB CONTRACTOR SUMMARY-AGREEMENT813700 TMO-700
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
Building and Code Regulations Division
RE D AUG 0 7 2014 SCANNED
BY
BUILDING PERMIT St. Lucie Count
SUB -CONTRACTOR SUMMARY v
T-Mobile
will be using the following sub -contractors for the
(Company/Individual Name)
project located at 2651Minute Maid Rd 1231-111-0003-000-5
(Street address or Property Tax ID 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 Company/Contractor
St. Lucie County/
State of Florida
License Number
Electrical
Stan Daemer Electrical
09E000299
Plumbing
HVAC/
Mechanical
Roofing
Gas
OFFICE USE ONLY:
PERMIT ISSUE DATE:
NUMBER:
Revised 07/29/2014
813700 TMO-700 A21"0049A
PERMIT# RECE1''0 AUG 07IN ISSLIEDATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division SCANNED
BY
BUILDING PERMIT St. Lucie Cot Int,
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor t=:eYnficationNumber. I C 0o0c) / 97
State of Florida Certification Number (if applicable):
.✓� -(1X)eNe OCe6t✓) Elea-1 a agreed to be the
(Company Name/Individual Name)
Ei_ECTRLCAL _ Suh-contractor for GLOTEL
(Type of Trade)
(Primary Contractor)
For the project located at 2651Minute Maid Rd 1231-111-0003-000-5
(Project Street Address or Property Tax ID #)
It is understood that, Mhere is any change of s'taftus regard'mg our participation WilhYne aoove mcrrtioned
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 t4ie Individual shovm onSl�e Contsxtoc's License}
NOTARIZED SIGNATURES ARE REQUIRED
Business Name: CGZS-i- Ocncr) C1ef4h r_ 01^ i- 10'- .44, =YtL.
Address:
City/State/Zip:
Phone: 50 I-LI89 .&3?J email:
(/ W oo:w7 O -7cb54- lac&-�e Ic-Z417P 8/
SIGNATURE PRINT NAME DATE
STATE OF FLORIDA, COUNTY OF
THE FOREGOING INSTRUMENT � WASSIGNED BEFORE ME THIS
WH PERSONALLY KNOWN I/ OR S
PRODUCED A-_ 0S IDEENN�TIFICATION.
Gl1��19 / j'��U22d1 t (STAMP)
SIGNATURE OF NOTARY PUBLIC PRINT NAME OF NOTARY PUBLIC
SLCPDS: 08/06/2014
,•• ".,, LINDA PALOZZOLA
Commission N FF 110250
My Commission Expires
April 07, 2018