HomeMy WebLinkAboutSUB CONTRACTOR SUMMARYPLANNING AND DEVELOPMENT SERVICES DEPARTMENT
Building and Code Regulations Division
SGANNED
BUILDING PERMIT BY
SUB -CONTRACTOR SUMMARY St. Lucie Countv
6__ 5`I i (a 16R will be using the following sub -contractors for the
(o ny/Individual Name) tt
project located at (Jy3 (7•VS "tWj:� I . ?or+ St-Luge_ a- jgS-d
(Street Qftes rop rty 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
c
`A car G
�0 SD a
Plumbing
_,c
MS e_CtA tk
M&cha" nica°F
1
Roofing
Gas
OFFICE USE ONLY:
PERMTI ISSUE DATE:
NUMBER:
Revised 07/29/2014
4
PERMIT q
PLANNING & DEVELOPMENT SERVICES
COUNTYiT
Building & Code Compliance Division
• BUILDING PERMIT s�HNIVED
SUB -CONTRACTOR AGREEMENT BY
St. Lucie County Contractor Certification Number: St. Lucie Countv
/
State of Florida Certification Number (If apptirable): C fi C / S 17 6 V3
fT""D-IF-rhave agreed to be the
(Company NarniA dividualName)
kW &Abif /o UiiU Fri Sub -contractor for �,"iCi ✓1 1�C tl I �
(Type of Trade) ' c� (Primary Contractor)
For the project located at 62-7 !3 � (;-kA 1 1-2Olk Q:k • LtiCt r 21
(Project Street Address or Property Tax ID N)
It is tfnddrstood 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 SL Lucie County by filing a
Change of Sub -contractor notice. (Farm: SLCCDV (No.00440)
BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License)
NOTARIZED SIGNATURES ARE REQUIRED
Business Name: / L
Address: �ne�C fS ENE
City/Statemp: y:�kcgi Agyzl-F E. ?V9,C7 /�
Phone: �%2 _/f7S- �f�t9 email: $POS/�tJS/� I !�/L ,C,v�
—r—�r
GIka,2,L s,�osrn� 2 Al
SIdNATURE PRINT NAME D T .
STATE OF FLORIDA, COUNTY OF Sr, L U C l E
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS .2 DAY OF / 19014 1h e r , 20 /4,
BY rrlacIt GS S!/V WHO IS PERSONALLY KNOWN OR HAS
PRODUCED r!5J9h&f 1114 IeW IZ14 AS IDENTIFICATIONYYK
d
(STAMP)
SIGNATURE OF VOTARY PUBLIC PRINT NAME OF NOTARY PUBLIC
SLCPDS: 081.062014
,�• $;;,, CNRI9TINE YITOLO
+ MY COMMISSION# FF 108398
EXPIRES: July 17, 2018
41, Bondad tAru NNWFuaa Unaewiran
w. PLANNING & DEV,KLOMVIE NT'SKRVICE-S.
' 8,11 ldiag-& Code CompliahIeUVida"
dull nt+r, pl aml'r _., _ � �illti Gt}LdTl2AGTCJR ,lt:R�Fr1k1r.CVsf' -
�r t ueiCa+pity t`ontratc r tcri{ionio$uTlunhcr ..
SlnSc`.ot'Flalidn i.CKtl4Jt1411 ,`,illrnl}Ct (tl'a�+pl:};ablt} �.�S2L��._......:.- -,•.
,`havc agreed t0 by the
\ x
i�ump:>�� umadtndit'idlrnl�n�sc),, F ,
{T raoCTradv) PrlmnryC3nunct4r7
Irttr the project located at, .._ Q �' --� — • ;...--=W
�taj�ot Strc¢t Addr�s of Ptopai�y "(t+x It7 a
It is �ndets(ooc that, ii' b'r is.any eltange oI`s attts regarding onr,partiaipat pn nith tl;e u ve mcritiar%ed'
pcujeKt ItivillimmecEiatelyadvisethe, Build" gaud,zonin�Department"oESt.TuiieCnun�}Aby#iltnga-
` G1ta�ygepfi�irb=citnCracttirrf�ticC; (Fornt SL�CU�ita.t}6n=tit7�: .
BUSIhTSS QUAl.l (E+ R (game aitii tndrvrdual stiq n oh tac contractors t.ieanse)
!lOTx�RlZ�U S1G[��STURF:S A[i� l2fr Q;Ui>Zr.IY '_
l3iuPat ss Name:
addtes+:
GPtylSrat�lZip. ��'J? L4.. m
ctnAll, ol.'
SIGN Itc PRhN r N AM It 11At (s.
sTAi r o r FLQRO)A, cou WlIV 0 F- SkA=4
"'lei l',kV}Cti V�ivV alvlanui?, ut, .r••Fu' ••••.••••, .-: .,' —�--
WFI4ISPTt;Sd1�ALJfttttN(154NniYtil'
CRifDI CED AS [DENTLCIC 1'Iov, x ,`
.�.s.._....—. rY�•:ry FppLi ^ `ll N t �(� P tpy../! v COMM" IE)
fRl�l����tf �1NU•��l•lt![IliT4 . • 1,�4MIIA.i:r�(niJ
SIGVATURE {III t\OTARY rt'tDLIG Radrdomwaft
ShCFDS, GWO &ZO i