HomeMy WebLinkAboutSUB CONTRACTOR SUMMARY-AGREEMENTPLANNING AND DEVELOPMENT SERVICES DEPARTMENT
Building and Code Regulations Division
0 ('HIVIVED
SUB -CONTRACTOR SUBUILDING IMMARY St. Lu�B County
Florida Mechanical LLC will be using the following sub -contractors for the
(Company/Individual Name)
project located at 4700 Midway RD, Ft. Pierce, FL
(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
Malanczyn Electric
EC-0001492
Plumbing
HVAC/
Mechanical
Roofing
Gas
Structural
Shell Subcontractors Inc.
CGC061261
PERMIT ISSUE DATE:
NUMBER:
Revised 07292014
PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number:
6CHNNED
it CuCBY
County
State of Florida Certification Number (If applicable):
rY1AL 4 NL Z VrJ G-"f r G�hi G `(„>✓ �. have agreed to be the
(Company Name/Indyidual f lame)
O�� /r ee, -t / Sub -contractor for Florida Mechanical LLC
(Type of Trade) (Primary Contractor)
For the project located at
4700 Midway RD Ft. Pierce, FL
(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)
BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License)
NOTARIZED SIGNATURES ARE REQUIRED
Business Name:
Address:
City/State/Zip:
Phone:
-77.�?- ;63 91%47
email: A M ti i a'.) G 4S-2 & /'10
(�IK
SIGNATURE PR/JINN NAME DATE
STATE OF FLORIDA, COUNTY
THE FOREG01NG INSTRUMENT WAS SIGNED BEFORE ME THIS DAY OF 20%�
BY �C J� /%ti !R r%'x�/�/ WHO IS PERSONALLY KNOWN OR HAS
PRODUCED
AS IDENTIFICATION.
S A RE OF NOTARY PUB C PRINT NAME 6F NOTARY PUBLIC
SLCPDS: 08/06/2014
(STAMP)
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