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HomeMy WebLinkAboutSUB-CONTRACTOR SUMMARY-AGREEMENTPLANNING AND DEVELOPMENT SERVICES DEPARTMENT NOBuilding and Code Regulations Division BUILDING PERMIT SCANNED SUB -CONTRACTOR SUMMARY BY St. Lucie County l� will be using the following sub- ontr ctors for the (Company/IndividualName)-7V1c?__.—60D7_ Uaacf project located at 77i `V f S 1.1 S/ wV ",—r/kr ji i (Street ad ressor 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 SL Lucie County. Trade Name of Company/Contractor St. Lucie County/ State of Florida License Number Electrical Qf Plumbing HVAC/( Mechanical MAI 312016 Roofing PER'.vii i St. Lucie Ceuniy, FL Gas PERMIT Revised 07/29/2014 PLANNING & DEVELOPMENT SERVICES " c Building & Code Compliance Division • U S , HUH I BUILDING PERMIT SUB -CONTRACTOR AGREEMENT SCANNED BY St. Lucie County Contractor Certification Number: oC. l0 1 y y St. Lue e GeLinty State cAlorida Certification Number (If applicable): E O / 3 6 O S T S 9 of Trade) For the project located at tX-01 . have agreed to be the Name) Sub -contractor for R- /n�lOn'a0.S l�n_q-f . nc, (Primary Contractor) '7 2 (o ( S . U , 5, qvi Street Address or 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 Business Name: Address: City/State/Zip: Phone: &- _ �% STATE OF FLORIDA, COUNTY OF t L"-g•E "AAY 3 1 LU10 PEF6,5i: 7 iiUG Lucie County, FL email: M i jta &p i aG - 2,QA a -04 i sa.L , C o ` THE FOREGOING' Q INSTRUMENT WAS SIGNED BEFORE ME THIS 21 DAY OF � � —20� BY �kl_u ' ` PV4R� WHO IS PERSONALLY KNOWN OR HAS PRODUCED AS IDENTIFICATION. SIGNATURE OF NOTARY PU LIB C PRINT NAME OF NOTARY -PUBLIC FPy�S-Fv ruy0` tP s• � SLCPDS:08/06/2014 �+�'°'.;� a •' 0as1 d