HomeMy WebLinkAboutSUB CONTRACTOR SUMMARY-AGREEMENT1
0
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
Building and Code Regulations Division RECEIVE®
SCNNNEL, NOV 2 9
BY BUILDING PERMIT 2016
St. Lude COW1tISUB-CONTRACTOR SUMMARY PERMITTING
/ 9 (�n St. Lucie County, FL
1 U Y /U / .hI lzcA cjj e— will be using the following sub -contractors for the
(Company/Individual Name)
project located at Si U-S I
S� +, 3 (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
C4. zV rkt
O o0 2 26
Plumbing
433 5L 5 k.fffC �-A-a
cEL1yaY 44,
HVAC/
441
Mechanical
Roofing
Gas
OFFICE USE'ONL:Yq
PERMIT 6 0 W ^ O 3 � / ISSUE DATE: /
NUMBER• (s /
R�isedo7n9nola
PERMIT# T, ` )t - GS ISSUE DATE
PLANNING & DEVELOPMENT SERVICES RECEIVED
Building & Code Compliance Division
SCANOM 2 9 2016
BY PERMITTING
St, LUCIp..7h(ijYN&Cour.r/. FL
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number:
State of Florida Certification Number (If applicable): CFC A 199-8469
5w_ Mini 1dWC,-G421114454 ING. have agreed to be the
(Company Name/Individual Name)
'LUM6INCA Sub -contractor for
(Type of Trade) (Primary Contractor)
Fortheproject located at��!�,U5f4U,)4 1 #3/3N15--50- 066S
(Protect Street Address TA ID M
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: 1L1145T—Pd= PLUMAI&C S ICC$1 1M
Address: a% I SW I_AKe;4L&rLK.
City/State/Zip:
Phone:
STATE OF FLORIDA, COUNTY OF } J t• a`e
Jr•
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS J_6 DAY OF 0C)J 20—&
BY
PRODUCED- - - ---
WHO IS PERSONALLY KNQWN OR HAS
�—
AS IDENTIFICATION.
(STAMP)
ALGWATURE OF NOTARY PUBLIC PRINT NAME OF NOTARY PUBLIC
SLCPDS: 08/06/2014
yew;,'°�, JEANAFFIEND
* � WCOMMISSION IFF92O
EXPIRES: October 14, 2019
�''caneT� Mid 7Aru Budget No"Saft
PERMIT # I I / ()G � ,.` S �_j' I ISSUE DATE
PLANNING & DEVELOPMENT SERVICES RECEIVE®
Building & Code Compliance DiviMuA ' NNrG NO, 2 9 2016
BUILDING PERMIT Sr L ey
SUB -CONTRACTOR AGREEMENT UNLZ G+O PERMITTING
n — Lucie County. FL
St. Lucie County Contractor Certification Number;-,J//�!� � /
State of Florida Certification Number (Ifap cable): . 6C 60V 2 �(03
have agreed to be the
Company
,Name/Individual Name) _
t✓Sub-contractor for l 213 �On� / A-r�Y1c� Tpx C
(Type of Trade) (Primary Contractor) o
For the project located at
#3 / 21 I - 5-61-
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
nRE/QUUI%ED'�/�l
Business Name:'�'V
Address: �SyNS�— B )O 1) LL"Uj*l.,=
City/State/Zip: _ J �s q ,f-Z --:S419 7
Phone: -172- email: JD I C
SIGNATURE
PRINT NAME DATE
STATE OF FLORIDA, COUNTY OF
.V
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS /(,* DAY OF Ill s o / , 204—
BY WHO IS PERSONALLY KNOWN V OR HAS
PRODUCED AS IDENTIFICATION.
r^ (STAMP)
1 �,�(�IUI� M r
ATURE OF NOTARY PUBLIC PRINT NAME OF NOTARY PUBLIC
SLCPDS:08/06/2014 AMFRMW
WCOMMWONIFFOW
• • EWIRE8:0daber14,2019
��tarw�� �iW6atl�tNmaySmira .