HomeMy WebLinkAboutSUB CONTRACTOR SUMMARY-AGREEMENTPLANNING AND DEVELOPMENT SERVICES DEPARTMENT
Building and Code Regulations Division SCANNED
BY
St. Lucie coimt,
BUILDING PERMIT
SUB -CONTRACTOR SUMMARY
� e_mp Jul pn $ will be using the following sub -contractors for the
(Compadi�ual Name)
project located at
313-a3a-Dof-oio-7 z/0K
(Street address or Property Tax
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
S,
�S b000 aa9
Plumbing
HVAC/
Mechanical
Roofing
Gas
OFFICE USE�ONLY
PERMIT ISSUE DATE:
NUMBER:
Revised 07/29/2014
PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number:
State of Florida Certification Number (If applicable):
KEMP SIGNS & SERVICE
Name/Individual Name)
ELECTRICAL
(Type of Trade)
SCANNED
BY
St. Lucie C6ufity
have agreed to be the
Sub-contractorfor KEMP SIGNS & SERVICE
For the project located at 4878 N KINGS HWY
(Primary Contractor)
(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 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:
1740 HILL AVE
WEST PALM BEACH FL 33407
Phone: 5 840-6382 email: PERMITTING@KEMPSIGNS.NET
STEPHEN M KEMP
SIGNATURE V PRINT NAME
STATE OF FLORIDA, COUNTY OF PALM BEACH
3/25/2016
DATE
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS 25 DAY OF MARC H
BY STEPHEN M KEMP WHO IS PERSONALLY KNOWN XX
PROPUCED AS IDENTIFICATI
r HEATHER COLLAZO
SIGNATURE OF NOTARY PUBLI PRINT NAME OF NOTARY PUI
SLCPDS: 08/06/2014
2016 -
OR HAS
HE
gTM A20
Notary P Ic - ajjpp of Florida
Commission # FF 923074
My Comm. Expires Jan 25. 202(