HomeMy WebLinkAboutSUB CONTRACTOR SUMMARY-AGREEMENTPLANNING AND DEVELOPMENT SERVICES DEPARTMENT
• Building and Code Regulations Division
OUAINNED
BUILDING PERMIT BY
SUB -CONTRACTOR SUMMARY if Imipr
.ounty
Da Usca0�0 (rJ �-Q*11 s' J:�V" will be using the following sub -contractors for the
(Company/Individual Name)
project located at 37 S Kcal ON114 4 ✓IC . V 4 , 1"i P/tc 6 31119 /
(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
S-i'w F oitt(,
Plumbing
HVAC/
Mechanical
Roofing
I
n �LCi/W f I olxf-IA o Xt-1c
zDds'rD�
�.[cln�GLp NC�wI-aoNn
Gas
PERMIT ISSUE DATE:
NUMBER:
Revised 07/29/2014
PERMIT # — ISSUE DATE
I . 4-
b`I i Y °
a _^ a. r
the
for the project located.at
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERNI.FT
SUB -CONTRACTOR -AGREEMENT
BY
St. Lucie Countv
have agreed to be
Sub -contractor for DACIE �oo(ro`I-) YMh+Ps xti`
(Primary Conhactor)
S�
134z- 701, -oaa3I000%
It'is understood that, if there is any change of status regarding our participation with the above mentioned
project, the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the
filing of a C44e of Sub -contractor notice.
l y-3 10nL ,r)+Q.rL
PRINTNAME
66z-17-5 3/,�8
COUNTY CERTIFICATION NUMBER
State of Florida, Coaoty of-6—
The toregoiag' tramtutwas a,gued before me this /dsp of
--�Q 20/% by--- Qdr1J �2LilIiL
who is Personally kaowo —or has produced a
r.
CONTRACTOR SIGNAT E tO alifierl
t~ f � �e (,/ 3 t"6 l0_t
PPM NAME
4'Y,2
COUNTY CERTfnCATION-NiIAIIIER
State oftlorida, emmty ofs iQ.
Theforepingimmameotwasdglneddbeforemeeiis Ldaymr
(f -I. 20 '�. by.
who is persoaalty kaown N/ or has Produced a
as identifiralioa.�'} (� j� �y
STAMP
t-5igaatpre afNofary ahfie (1
PriatName oFNotary Pohlie —�� .i--
' �^ AUDREYB.HUMPHREY a"'{'"*., IAURAR.CUBBEQGE
Revised t7I162076 � MY COMMISSION#FF 174772 ? � Ccmtrvssron#6Ca 022076
EXPIRES: March 6, 2019 s- Expires October21.2020
%A6,5"t.°C Bonded Thor NolaryPUGic Underwriters 9�0.+'�m�T.�,�I�ygyylpq..98S7079
PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number.
State of Florida Certification Number (If applicable):
0Wil%4IUi:L)
BY
St. Lucie County
ILt C ku 114 ILOp f`v/L d—(F> ,TiJLG have agreed to be the
mpany Name/Individual Name) /
Sub -contractor for d�Adf a�o�rr� /p`1jpS L�
(Type of Trade) (Primary Contractor)
For the project located at X"Y— 13/ 7i 707, OD03 Oo 01_7
(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: Q ,L+ �4-
Address: b -) o y S�q
City/State/Zip: I -f
Phone: �7'L (tby ' 3]o1)5 AI email:
iLWW`✓' /�/ O /-7
SIGNATURE PRINT NAME DAT
STATE OF FLORIDA, COUNTY OF Sfi Lu C I-f
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS _ DAY OF 1,( Xe,/� 20�
p 1. L 4, _ __ cK
PRODUCED
SLCPDS: 08/06/2014
AS IDENTIFICATION.
r V MYCAM,EE883700
"1 EXPIRES: MAR 13, 2017
PUBLIC, '" Bonded through tat state Insurance
4
i
PERMIT# OD bS ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT 6L;ANNE®
SUB -CONTRACTOR AGREEMENT BY
3t- Lucie County
(cjn t" 4-4tf - &A 5L Cd 1 ' C _ have agreed to be
(o any Name/Individual Name) /'
the p�� ✓r 0. Sub -contractor for -D AyE (90( CELJ G S rL C
(Type of Trade) (Primary Contracto'r)/
For the project located at 3 Z 5� /gAn ao/Lq Ad6 ICI, (/ ir?kef,
(Project Street Address or Property Tax ID #) p �3�2 — O oD Oo z�T i- /3
It is understood that, if there is any change of status regarding our participation with the above mentioned
project, the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the
filing of a Cba6*e of Sub-contlactor notice.
IGNATURE (qualifier) NTRACFOR SIGNATURE (Qualifier)
PRINT
CUTY CERTIFICAIZ' ON T ER
State of Florida, County of ✓�/ �^
The foregoing instrument was s' fore me this-9day
yoof
Tb/'L L .20L by� i N
who is personally kno va _or has produced a
as ide h
STAMP
Signature of Not buc
, y I
>no'� /" 5i. M'214151' 7
Print Name of No rPublic
Revised 11/162016
20 54,6
COUNTY CERTIFICATION NUMBER
State of Florida, County of �f �,,., i(.�
The L foregoing instrument was signed before me this ?j t day of
U V(lL .2011 by �Rl chard W4?L—)l0.l-i
who is personally knowu�—ar has produced a
as identification.
`-L_—t' — STAMP
Signature of Notary Public
Print Name of Notary Public
p a+.
,i�.-"'•.�-_
MELISSACOLE
MY COMMISSION #FF137459
EXPIRES September 14, 2018
(407) 39"153
FloridoNota Servise.onm