HomeMy WebLinkAboutSUB CONTRACTOR SUMMARY-AGREEMENTo
PLANNING AND DEVELOPMENT SERVICES DEPART3WK
Building and Code Regulations Division By YCL
St. Lucie Count,
BUILDING PERMIT
1 SUB -CONTRACTOR SUMMARY
LOGO 6 M K� �N 1 N L will be using the following sub -contractors for the
(Company/Individual Name) '5_1 O 1 AJ, 14WY
project located at Y'-r5a2T.�7 co•oPP liv(^i P1 A-erc_p r-L
(Street address or Property Tax ID #) 3 t.[ 61 `•[ 9
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
111VAC/
Mechanical
Roofing
Gas
A-t
zLf INi/WP2f4 �31 �o
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S Tc- , s'
sE/ a, 7 6
PERMIT ISSUE DATE:
NUMBER:
Revised 07/2912014
UPle_
PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT SUANNtL,
St. Lucie County Contractor Certification Number: CBY OUnYt
State of Florida Certification Number (Ifapplimbie):
FA
have agreed to be the
(Company Name/Individual Name)
�y/PUg�p/ Sub -contractor for /i--000l /flg 162 s/p- e2is� WG.
(Type of Trade) (Primary Contractor) g
For the project located at �e&ll ,��A>Ls (fiJ - HP �ln/C 3� 6 64 GLi/ a 4y
(Project Street Address or P operty 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)
BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License)
NOTARIZED SIGNATURES ARE REQUIRED
Business Name:
Address:
City/State/Zip:
Phone: ��� — O �120 email:
�ne I' C.owis $ (� Zo/(p
SIGNATURE PRINT AME DATE
STATE OF FLORIDA, COUNTY OF
THE FOOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS DAY OF GIH6l� 20��
BY If0/1PJ .Iunser Louts WBO IS PERSONALLY KNOWN OR HAS
PRODUCED rt6A, aaiTrNWANNTHOMAS
:OM.!••:cc�9°�A3997 (STAMP)
EMPIRE! -'\... <-
SIGNATURt OF NOTARY PUBLIC
SLCPDS: 08/06/2014
BRITnNEY ANN THOMAS
hiY COMMISSION #FF983907
EXPIRES: APO 19, 2020
. JuGuo tsl State Insurant