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HomeMy WebLinkAboutSUB CONTRACTOR SUMMARY-AGREEMENT813700 AT&T Saq Turf PLANNING AND DEVELOPMENT SERVICES DEPARTMENT Building and Code Regulations Division SCANNED BUILDING PERMIT BY SUB -CONTRACTOR SUMMARY St. Lucie Countv Mastec Network Solutions will be using the following sub -contractors for the (Company/Individual Name) project located at 2651Minute Maid Rd 1231-111-0003-000-5 (Street address or Property Tax ID i) 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 Mastec Network Solutions l;C 13oa6K q- Plumbing HVAC/ Mechanical Roofing Gas OFFICE USE ONLY.: PERMIT f I ISSUE DATE: NUMBER: 11 ���� Revised 07/292014 812 700 AT&T Saq Turf EMIT # 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): Mastec Network Solutions (Company Name/Individual Name) ELECTRICAL (Type of Trade) tc ► cluq K SCANNED BY St. Lucie Countv have agreed to be the Sub -contractor for Mastec Network Solutions (Primary Contractor) For the project located at 2651 Minute Maid Rd 1231-111-0003-000-5 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) QUALIFIER (Name of the Individual shown on the Contractor's License) NOTARIZED SIGNATURES ARE REQUIRED ekFw� Business Name: M0.5`i%f- o `�- 50 l �/ i-10 /I - Address: -JIB iA(l= Fore 5+- 0 City/State/Zip: C6ey A 1JC 2752-7 Phone: email: L ��-,C SIGNATURE STATE OF FLORIDA, COUNTY OF PRINT NAME �lid�b DATE THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS 13 DAY OF (,A a�L 1 , 20-1(p— &Itl OR HAS BY/2YGtC%Cet WHO IS PERSONALLY KNOWN PRODUCED ( (Ntc6cea 'e. —AS IDENTIFICATION. pI�DEN luTIFt� �/U(ni2 tL l� 6/ bPU_� (STAMP) SIG ATURE OF NOTARY PUBLIC PRINT NAME OF NOTARY PUBLIC SLCPDS: 08/06/2014 _. o "a�- A. MONIQUE NICOLI NOBLE AoMY COMMISSION #FF080936 `Z, 6, nod;.' EXPIRES January 5. 2018 (407) 39"150 FlertcaNalarySeNice.eom