HomeMy WebLinkAboutSUB CONTRACTOR SUMMARY-AGREEMENTPLANNING & DEVELOPMENT SERVICES
BUILDING & CODE COMPLIANCE DIVISION
oVANNED
BY
BUILDING PERMIT it ,_ucie County
SUB -CONTRACTOR SUMMARY
_ e" +G will be using the following sub -contractors for the
(Coa.pany/lndividual Name)
project located at V d9l — U OG/ — a 6
(Street addressor Property Tax
"s"
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
I_ _ llIOA'�z'/�' Z--:v0o
di�EC:�v7y t�CfX�Gq l CQivTitsu
�f�s
�fao�Z71
Plumbing
HVAC/
Mechanical
Roofing
- ---
Gas
— — —
OFFICE USE ONLY:
1. PERMIT ISSUE DATE:
NUMBER:
PLANNING & DEVELOPMENT SERVICES
d ` Building & Code Compliance Division
OR
SCANNED
BUILDING PERMIT BY
SUB -CONTRACTOR AGREEMENT St. Lucie Countv
St. Lucie County Contractor Certification Number: /�+f
Vr
State of Florida Certification Number (If applicable): �J V' DOO ,? 7/
w�.z ywez` Z40"q /60—ferd^t— have agreed to be the
(Company Name/Individual Name)
f' !y sub -contractor for _ - L #P*e",r L,;dDO
(Type of Trade) (Primary Contractor)
for the project located at 3 el 154 — , 4w - G ,fo —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 Department
of St. Lucie County by personally filing a Change of Contractor notice. (Form: SLCCDV
No. 004-00)
BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License)
®RIGINAL SIGNATURES ARE REQUMI)
IGNATURE
PRINT NAME DATE
Pfione:
T email:
W,r," ;;rAwd, &