HomeMy WebLinkAboutSUB CONTRACTOR SUMMARY-AGREEMENTPLANNING AND DEVELOPMENT SERVICES DEPARTMENT
Building and Code Regulations Division
SCHNNEL,
BY
SUB-CONTR ACTOR SUAPAARY St. Lucie t
IT e Count,
Martin County Propane will be using the following sub -contractors for the
(Company/Individual Name)
project located at 14191 Rangeline Road
(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
Weezer Electric
EC0001360
Thomas Jeffers
�ZZ12
Plumbing
HVAC/
Mechanical
SEE
C EIVIERD
Roofing
$
P 2-2 2016
Gas
OFFICE USE ONLY:
PERMIT ISSUE DATE:
NUMBER:
Revised 07/29/2014
PERMIT #
ISSUE DATE
PLANNING & DEVELOPMENT SERVICES SCANNED
Building & Code Compliance Division BY
St. Lucie Comb/
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number: I I I 1
StateofFlorfdaCertification Number (if applicable): 45C,000 f T 6 o
have agreed to be the
Ede c fg lcm C _ Sub- conttSte tortor-- MROA (DUyy)P �P
(Type of Trade) (Primary Contractor)
For the project located at 4233-111-0001-000/6
(Project 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)
BUSMSS QUALOM, R (Name ofthe Individual shown on the Contractor's License)
NOTARIZED SIGNATURES ARE REQUIRED /
Business Name: bV et z, efz EI'&G L'C(.I
Address:
c;tyrsrmerzip: (� Pnm, n _4e1, FL 33660
Phone: 7S�I 'G%f%6-65 email: Grl%p,,t,2.f2dd2fiTit rG t/.NTi. NEi
r l-hcmAs f' e �' ns gla/4 6
SIOXATWPR NTH NAME DATE
STATE OF FLORIDA, COUNTY OF U,W 14)/` -91)
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE NIE THIS ),l DAY OF 20
BY 714 IP Tr— F1 WHO IS EBSONALL OWN OR HAS
PRODUCED
_ .,,4 ;,..... annei*nnuI Ieu F (STAMP)
'-AsMP 's Notaty Public - State of Flonda
SLCPDS:12 fi=3 I 's`° " Bonded Through National Nrna•.