HomeMy WebLinkAboutSUB CONTRACTOR SUMMARY-AGREEMENTFROM :FRISCIA ENGINEERING FAX NO. :7723407996 Sep. 16 2015 09:34PM P2
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PLANNING AND DEVELOPMENT SERVICES DEPARTMENT 'PeC4�
Building and Code Regulations Division /GO
SCANNED sF1
BUILDING PERMIT S4. Lucie County
SUB-CONTRAM'OR SUMMARY `y
k
6' Y-P.�4 0, fo will be using the following sub-eontractors for the
paa ndlvidual Name) Q
project located flt� ^����
(Street address r Property Tax IU #
It is understood that if there is tiny 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. Lurie County.
Name of Company/Contractor
St. Lucie County/
State of Florida
License Number
FTmdc
Plumbing
_._..._
HVAC/
Mechanical
Roofing
--.--�_
_ Gas
)FOICE USE ONLY:
PERMIT ISSUE DATE:
NUMBER:
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FROM :FRISCIR ENGINEERING FRX NO. :7723407996 ,Sep. 16 2015 09:34RM P1
RECEIV70 SEP 161015
lt6o ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division SCANNED
BY
St. Lucie County
BUILDING FRRMIT
Su 8-CONTRACTOR AGREEMENT
St. Lucie County Contractor CertificationNurnW:_—
State of Florida Certification Number(Vaglicable):
p c3 have agreed to be the
(Company Namdtrdi idual Name)
_ St6e,(- Fa br1e-0.1.6 (— _— Sub -contractor for ,r.AA_J A44
(Type of Trade) A(Pri aryContractor) ��c
For the project located at 9�7 5 At lfq� / t�t� gas —e E-� 3�-q. !
(Project Strcel AIldress or Property Tax ID N)
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 and7.oning Department of St. Lucie County by filing a
Change of Sub -contractor notice. (Form: SLCCDV (No. 004-00)
BUSINESS QUALIFIER (Name of the Individual sbown on tile CDntrneter's License)
NOTARIZED SIGNATURES ARE REQUIRED
0-0ifm LOOK - -- V/IQIS- .... ..-
- ---PRINT NAME- ---- - - DATtL ---- -----
TIIE FOREGOING `INSTRUMENNT WAS SIGNED BEFORE M E THIS —DAY OF ESQ D j��s
BY ��` WIIO IS PERSONALLY KNOWN OR HAS
SLCPDS: 08/0612014
(STAMP)
rSllpnys , CINDY M. MINE
W7TARY WDLIC
a STATE .7 FLORIDA
C•Yam# EE102000
ls$1: ' E;4NreS 3/27/2016