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HomeMy WebLinkAboutSUB CONTRCTOR SUMMARY-AGREEMENTPLANNING & DEVELOPMENT SERVICES DIVISION BUILDING & CODE REGULATIONS DIVISION 2300 Virginia Ave Fort Pierce, FL 34982 SCANN1:1 BY BUILDING PERMIT St. LuCfe Cot inr SUB -CONTRACTOR SUMMARY k IAA-C A C,Ou 3MQCA-�00 (Companytradividival Wamol project located will be using the following sub -contractors for the 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 O�© Plumbing HVAC/ Mechanical Roofing Gas OFFIgel 6 Y? PERMIT ISSUE DATE: NUMBER: PERMIT # ISSUE DATE PLANNING & DEVELOPMENT SERVICES r . e.cr Building &Code Compliance Division RE � SCHt� BUILDING PERMIT 1 2 2016 SUB-COrTj{AO�ROAGREEMENT St. LUci��fNIr1yItgG St. Lucie County Contractor Certification Number: DD(( _r✓J St. Lucie County, FL State of Florida Certification Number (If applicable): .Y have agreed to be the Name) .. Sub -contractor for 20 (Primary Contractor) For the project located at ! d 3 3 NO 1 , (Project Street Addressor Prope x #) _ It is understoo that, if tlirare is c ou e o status r ar tng o partt'cip�h�on�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: Address: City/State/Zip: Phone: )(26C a_0l c�3 j0,y 16w fc�' 1 S t� L PRINT NAME DAT STATE OF FLORIDA, COUNTY OF 1 L y`CU Q /✓_ &6 THE FOR�EGnOING'/INSTRUMEN WAS SIGNED BEFORE ME THI` DAY OF BY I t/ �+/` Y L Qi I �� Il t� WHO IS PERSONALLY KNOWN OR HAS PRODUCED AS IDENTIFICATION. (STAMP) OF NO' Y PUBLIC/PRINT NAME OF NOTARY PUBLIC SLCPDS: 08/06/2014 ..+" r'o"••. MISTY LUNDEEN it': Notary. Public - Stile of Florida �a,•Q Commission Y FF 956571 •'•°� ��"° My Comm. Expires Apr 25, 2020 Bonded through National Notary Assn.