HomeMy WebLinkAboutSUB CONTRACTOR AGREEMENTPERMIT# i509-045q ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
® ' J -J 1' Building & Code Compliance Division SC AN
BUILDING PERMIT St. Lucie COUTP
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number:
State of Florida Certification Number gf applicable): FL#RF11067372
Jensen Beach Plumbing have agreed to be the
(Company Name/Individual Name)
►Pt % Aw bt r Sub -contractor for ]lc n,. r +- (1u nSTi r• j r F r S
(Type of Trade) (Primary Contractor)
For the project located at la, 5 U S Fhu,11 R 4 �f Ludy F+ 81iaSa - LULI -5C11 — 5001-2.Sn--r
( iectct Strcet Property'1'ax 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 filing a
Change of Sub -contractor notice. (Form: SLCCDV (No. 004-00)
BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License)
NOTARIZED SIGNATURES ARE REQUIRED
Business Name: Jensen Beach Plumbing
Address: 1086 NE Industrial Blvd
City/State/Zip: Jensen Beach, FL 34957
Phone: 772-22"600 email: renee-jbplumbing@bellsouth.net
�Gz / Lonnie Culbertson 11/2412015
SIGNATURE PRINT NAME DATE
STATE OF FLORIDA, COUNTY OF /�li� ptc2
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS &V DAY OF /yQ ✓eM be z 120 1 S
BY Lonnig, CILI 0 WHO IS PERSONALLY KNOWN t// OR HAS
PRODUCED AS IDENTIFICATION.
4�2
I•
� /," //,� —�QehjA )111ls6,0
NAT OF NOTARY PUBLIC PRINT NAME OF NOTARY PUBLIC
SLCPDS: 08/06/2014
�..n.''"c`,^ JACLYN IFWILSON
!.i A. \
h1Y COMMISSION #FF759777
EXPIRES November 8. 2018
(4117) 395-0153 FloridallotaryServicexom
(STAMP)
PERMIT # iq O� ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
<
St. Lucie County Contractor Certification Number: � -7 /� -—
-�
State of Florida Certification Number (If applicable): —A C /Z D O.,? 7G 6,
oe
SCANNED
BY
St. Lucie Countv
have agreed to be the
0 Uze4l }f IC (kAn Sub -contractor for �, , ,-W.� ...,). 0n n•crf. ,n � ten n &[i2zT 5
(Type of Trade) (Primary Contractor)
For the project located atlrtnntrx,r,2 3vgsa �vlu Sof soo( asn-�
(Project Street Address or Properiy'V2 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 filing a
Change of Sub -contractor notice. (Form: SLCCDV (No. 004-00)
BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License)
NOTARIZED SIGNATURES ARE REQUIRED
Business Name: Z5101 z)t CD �9(2-k ZZF-L
Address: /--2
City/State/Zip: J
Phone: email: ��E�EC77��/L'jar� fJr2�l
DATE
SGNATURE�_
PR�IN/T/NAME.Tl
STATE OF FLORIDA, COUNTY OF /' f ,11Z P 1
THE FOREGOING INSTRUMENT WAS SIIGNED BEFORE ME THIS -2—Z DAY OFF—N—V—., 20�
BY -J Glj✓tc� f�L'L° (c P WHO ISPFRSIDALLYN KNOWN�OR HAS
PRODUCED
AS IDENTIFICATION.
(STAMP)
/SIGNATUAE OF NOTARY PUBLIC PRINT NAME OF NOTARY PUBLIC
SLCPDS; 08/06/20142JACLYN F WILSON
MY COMMISSION#FF159777
EXPIRES November 8, 2018
Fl,ndaNDlarySevice,DOm