HomeMy WebLinkAboutSUB CONTRACTOR AGREEMENT/Iq _.
PERMIT# 1703-004 I ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
I V E
Building & Code Compliance Division
SC BY EDAPR 13 2Q17
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT St. Lucie COullkR6FiITTING
St. Lucie County, FL
St. Lucie County Contractor Certification Number:
State. of Florida Certification Number (if applicable):
EC0001643
Centerline Solutions / Todd Schlemmer have agreed to be the
(Company Name/Individual Name)
ELECTRICAL Sub -contractor for Anthony Ankersmit / UCI Construction Services, LLC
(Type of Trade)
(Primary Contractor)
For the project located at 1480 Dyer Road, Port St. Lucie 34952 (VZW Site 62707)
(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: 7103 East 6th Avenue
City/State/zip: Tampa, FL 33619
Phone: 813-386-6202
Anthony
SIGNATURE PRINT NAME
STATE OF FLORIDA, COUNTY OF Hillsborough
email: ddrury@ucics.net
Ankersmit
4/7/17
DATE
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS 7th DAY OF April
BY Anthony Ankersmit
2017
WHO IS PERSONALLY KNOWN X OR HAS
PRODUCED AS IDENTIFICATION.
bzbrp _M_. DOA-�04 Debra M. Drury (STAMP)
SIGNATURE OF NOTARY PUB C PRINT NAME OF NOTARY PUB
SLCPDS: 08/06/2014 b*• °w,, DEBRA M. DRURY
Notary Public - State of Florida
Commission# FF 973213
My Comm. Explm May 28.2020