HomeMy WebLinkAboutSUB CONTRACTOR SUMMARY-AGREEMENTPLANNING AND DEVELOPMENT SERVICES DEPARTMENT
Building and Code Regulations Division
BUILDING PERMIT SCANNED
SUB -CONTRACTOR SUMMARY BY
St. Lucie County
W31W_1,e( will be using the following sub -contractors for the
(Com any/Individu 1 Name)
project located at 6189 North U.S. Highway 1. PID#: 1406-413-0003-000-8
(Street address or Property Tax ID #)
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
l �ro�r .L
Plumbing
IWAC/
Mechanical
Roofing
Gas
R PNUMBER: I ! ISSUE DATE: tl
Revised 071292014
PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
SCANNED
BUILDING PERMIT BY
SUB -CONTRACTOR AGREEMENT St. Lucie County
St. Lucie County Contractor Certification Number:
State of Florida Certification Nun�er (Ifappiieable): Ec lma 7Z
tlanal Ir,w l .a.,otov, have agreed to be the
(Com1pany Name/Individual Name)
�eLTr;cwl Sub -contractor for
(Type of Trade) (Primary Contractor)
For the project located at
6189 North U.S. Highway 1. PID#: 1406-413-0003-000-8
(Project Street Address or Property Tax
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 sbown on the Contractor's License)
NOTARIZED SIGNATURES ARE REQUIRED
Business Name:
WAS SIGNED BEFORE ME THUS _ J_ DAY OF
IR HAS
PRODUCED AS IDENTIFICATION.
'afif� SU (STAMP)
OF NOTARY PUBLIC P T NAME OF NOTARY PUBLIC
SLCPDS:08/06/2014 •,;n'+;o'•••., MICHAELSABOL
Commission#FF964896
ExpiresFebruary25,2020
Bonded TAruTmy Fain Insurance 800.385.7019