HomeMy WebLinkAboutSUB CONTRACTOR SUMMARY-AGREEMENTPLANNING AND DEVELOPMENT SERVICES DEPARTMENT
Building and Code Regulations Division
SCANNED
BUILDING PERMrr BY
SUB -,CONTRACTOR SUMMARY St. Lucie County
l ,a Tom.1,4 G K i - will be using the following sub -contractors for the
(Company/Individual Name)
project located
'1 � N
i PlE"e— F134f ITY1
or Property Tax ID t)
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
Plumbing
HVAC/
Mechanical
Roofing
Gas
L (eva }dam
AL e l-Y,46'ts Lc.LC.
5-rA-T is G `t `
(
oF>�ci��fsE olvr;�t
PERMrr ISSUE DATE:
NUMBER
Revised 07/29/2014
AUG/12/2016/FRI 08:17 AM Ocean P- marts Co -OP FAX No.
i
RECEI`." 'u AUG 12 2016
P. 001/001
PERMIT# f ISSUE DATEOI
L®
PLANNING & DEVELOPMENT SERVICES ,
Building & Code Compliance Division rk, Big'
g
auu4BAVCPBRMIT SCANNED
SUB-CONTRACTORACREEDIENT St. Lucie St. Lucie County Cantractor Cettificadon Number, St. County
State of FloridaCemfiic�cattionNumber(ifa"Hcsb)e): �C70[JtT�-:{4
CIJ have agreed to be the
(Comar Nameftdn idual Name) y
fit E C. Yi c, Sub -contractor for
(Typc of Tmde) n f (Primary Contractor)
For the project located at 0(- yt NPCt1rFS -C-10I
It is understood that, if there is any change of status regarding our paiticipatitm with the above mention(
project, I will immediately advise the Building and Zoning Department of St. Lucie County by filing a
Change of Sub -contractor notice. (Forst: SLCCDv (No, oD4-oo)
BUSINESS QUALIFIER (K=c of the Judividusl shown on the Contractor's License) I
NOTARIZED SIGNATURES ARE REQUIRED
Business Name: ��� 1✓�r-V' .E 1
Address: Ce.rrl4(� , LG. L-�
N- '
I
City/State/Zip: V e� 6x 19
Phone: 772. T&ci - 1-7 J!r emaite CAd ctI C. �� c, `
AVA;
SIGNATURE PRM NAM DATE
STATE OF FLORIDA, COW= OF
THE FOREGOING INSTRUMENT
WAS SIGNED )BEFORE NE THIS '7 DAY OF &VaLz— ' 20k
WHO IS PMONALLY MOWN ORBAS
IDENTIFICATION.
PRINT NAME OF NOTARY PUBLIC
CAROL J. GRIFFI I
NOTARYPUBuo
STATE OF FLORID
EVIfea; 2123f2018
(STAMP)
40f"i<
PERMIT # S L C ' �(o O (p ISSUE DATE �%_ s— ZOI (o
PLANNING & DEVELOPMENT SERVICES SCANNED
Building & Code Compliance Division BY
St. Lucie Counts
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number:
State of Florida Certification Number (if applimble): CC Z 7 %
have agreed to be the
(Company Name/Individual Name) �
js)d.v� la ✓ Sub -contractor for (rood %orra -10 /5�n24e�l
(Type of Trade) (Primary Contractor)
For the project located at
Street Address or Property
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:
Phone:
email:
vt LA 6S
SIGNATUkE PRINT N 'IE
STATE OF FLORIDA, COUNTY OF
, , U
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS gS DAY OF
C�_"
F-
DATE
BY J�O rWJ —6vn #' or Low 5 WHO IS PERSONALLY KNOWN OR HAS
PRODUCED n u
SIGNA OF NOTARY PUBLIC
SLCP S:OS/06/2014
IDENTIFICATION.
PRINT NAME OF NOT
BRM.y ANN IHOMAS
0 MY COMMISSION #FF983907
/ \'o FXPiRES APR 19, 2020
�:vt 8onatoMEMO Iststate lasutanca
(STAMP)