HomeMy WebLinkAboutSUB CONTRACTOR SUMMARY-AGREEMENTr � ,
�a PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
Buililmgarid"CodeliegaTatlons"Division �'��������
SCANNED APR 13
BY 2016
BUMDWG PERMIT t Lucie COun�� PER.'AITTI,UG
1 SUB -CONTRACTOR SUMMARY rySt. Lucie County, FL
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C MMO�iP� ri61 n ^L, will be using the following sub -contractors for the
(Company/IndiVidual Name) /� j�
project located at �Q I O fQyiGF 1'� ur I C� �g�� 1 �45
(Stre -dress 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
Crpt O f I r,
?j
Plumbing
HVAC/
Mechanical
Roofing
Gas
VFFICMk Ig ONI.I
PERMIT I ISSUE DATE:
NUMBER:
Revised 07292014
PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES'RECEzI E
Building & Code Compliance Division APR 1 3
a 2016
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number:
State of JFlorida Certification Number (Wapplicable): GG I3M 2 5 _%Z
JC.rt �.- f C- / InrAncln have agreed to be the
—�(C mpan Name/Individual ame)
Sub -contractor for j CkIJn'� c
(Type of Trade) (Primary Contractor)
For the project located at
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)
SCANNED
BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License) BY
St. Lucie County
NOTARIZED SIGNATURES ARE REQUIRED
Business Name:
Address:
City/State/Zip: W,4 `r-1,nyg_pcTn rt 17)
Phone: S61 54t G550 email:
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ZU SPRINT NAME p APE
STATE OF FLORIDA, COUNTY OF
THE FORjEGOI�N]G INSTRUMENT .WAS SIGNED BEFORE ME THIS G DAY OF AoJ , 20k!
BY I Ipwr, �dAM&Q WHO IS PERSONALLY KNOWN OR HAS
PRODUCED
i
TURE O NOTARY PUBLIC
AS IDENTIFICATION.
LJ (STAMP)
a
PRINT NAME OF NOTARY PUBLIC
SLCPDS: 08/06/2014
MICHAELSABOL
' Commission # FF 964896
ao' Expires February25,2020
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