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Home My WebLink AboutSUB-CONTRACTOR AGREEMENTPERMIT# ISSUE DATE d PLANNING & DEVELOPMENT SER 'ECEIVED ' Building & Code Compliance Divon NOV 1 9 -0113 BUILDING PERMIT SUB -CONTRACTOR AGREEMENT �, LudeCounty, Permitting SCANNED BY St. Lucie County 9? .5L For the project located at PLO 5• ocew 170-1 4 1 U%E4s eeAch- IcL x Street Address or Property Tax M 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 Change of Sub -contractor notice. TAACfOR SIGNA aatiBer) I�4rcF2-To G rr3�Ss � PRINT NAME G6C12.5o1o'2 COUNTY CERTIFICATIO R State ofFlorlda. County of G Mt eforeg laglnstrumentwass ed fore ethts� t o P who Is person ly Im A orhaspLaced. CRISPIN ' ' Commission s GG 247588 My Comm. Expires Aug 9, 2022 �d through National Notary Assn. Revised 11/162016 f'i .Tu 7 (SUB -CONTRACTOR SIGNATURE (Qoallaer) ce.l'.y,llat< PRINT N iFz, xo 2-o,5 COUNTY CERTIFICATION NUMBER State of Florida, County of Mar+: n The foregoing hatrament wasalgned befo , f n b 20jy� by who Is personally Mom STAMP EGEORGE dINUEZA otary Public, State of R6dd9Commission/) FF 938900 corm. expires Nov. 24, 2019 PERMIT # ISSUE DATE PLANNING & DEVELOPMENT SERVICES Building & Code Compliance Div slon RECEIVED BUILDING PERMIT NOV 1 9 2018 SUB -CONTRACTOR AGREEMENT ST. Lucie County, Permitting /17/l5e*2.-� T lc&wz)hd/ have agreed to be (Company Name/Individual Name) ll''^_ the ✓/a/»hiNG Sub -contractor for e � J y�a�ft'�� I/C Type of Trade) (Primary Contractor) For the project located at (Project Street Address or Property Tax ID #) OPC/, FL 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 Change of Sub -contractor notice. CTOR SICNA (QuaRaer) PRINT NAME Psi k ZS 40-1 <D'Z CO[JNTY ER, Count of ION NPMER State of Florida, County of t i The foregolo instrument was sa ned b on me"thiiss 2 of ' who is perso9 y knper o90 koo n _or has reduced a_� fWyllbblic - State of Florida Commission 6 GG 247588 Comm. Expires Aug 9. 2022 through National Notary Assn. Revised 1111617016 STAMP COUNTY CERTIFICATION NUMBER Gam(,/�F� ` State o[Florida, County eC fVU+in The foregoing instrument was signed before me this f&�er WZWkZr 0 J%�VI who is personally Imos� or bas produced a of . nrtq, o � ,, RE " H HOY A 'o Notary Public - State of Florida ° ` Commission d FF 185910 .; alto:•` My Comm. rxpirew Feb 17. 2019 STAMP PERMIT # ISSUE DATE PLANNING & DEVELOPMENT SERVICES Building & Code Compliance Divisioqi BUILDING PERMIT SUB -CONTRACTOR AGREEMENT O L A)w NOV 1 9 2018 ST. Lucie County, have agreed to be (Company NameAndividual Name) �" the 76 g— �S54 ate- Sub -contractor for rc/1DE&i (ev`l�C7o� (Type of Trade) (Primary Contractor) �� For the project located at (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, the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the filing of a Change of Sub -contractor notice. RACTOR SIGMA (Qualifier) RQ-�� P NT NAME State of Florida, County of UYrlt The foregoinj instrument was sigu/ed fore me this o`f_ 20Z by_V1 II, who is personal own or has produced e as identifsce STAMP Signature MARLENE C CRISPIN o p -'Li -mmission # GG 247588 My Comm. Expires Aug 9, 2022 Bonded through National Notary Assn. Revised 11116/2016 5CC 63 t I15�12-(o3 COUNTY CERTIFICATION NUMBER State of Florida, County of 1n 0 0 J4Iev The foregoing instrument was signed before me this —2— day of Xyyethbee ,20i, by a&&Ar—f MY -1 * ' who is personally Imown —.r—o—r has produced a as identification. guy `of Notary Public / O MP I 1411)r Pont Mme of Notary Public A HADLEYOMMISSION RM9DA #FF181881ES Decemher 8, 2018titlallotaryService.com ,x-- 4ft 40 PERMIT# I V l I- 10� _ 5. I ISSUE DATE PLANNING & DEVELOPMENT SFYR*4WS Building & Code Compliafiq I s'on FO sF 4i�9 , �101 BUELDMPERMrr SUB -CONTRACTOR AGREEMENT I u A 4%J" have agreed to be (Company Namellndividual Name) C sn�zwq the Ifil J Nu )s/UQo r s Sub -contractor for $5-�� 7'1 (Type of Trade) (Primary Contractor) For the project located at TaxID 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 Corll be advi)gd pursuant to the filing of a Change of Sub -contractor notice. COO AMR SIGNATURE(Qualifier) PRINT NAIVE COUNTY CERT ncATION NUMBER � t-( d Aoy-A, q PRINT NAME COUNTY CERTIP[CATION NUMBER State of Florida, Countyot mwu. & State of Florida, County of��(/K— TuThhe foregoing instrument was signed before me thCat day of The foregoing instrument was signed before me this of at....ar zoao by foba�Fo l3. �`css\o �a(\ zoDDby who is persoualiy known has produced a F�Or`,� �C„M.r�� who R personally known _or bas produced a f- l DL, as ideatifinCtioo.V STAMP (," j STAMP Signature of Notary PCuubW Printxame of Notary Public ••y:i'; ••.,, SHIRINYAZOANI Notary Public - State of Florida Commission OGG 145540 Revised 11116fl016 '••h�� ;,'r""r `^�C^.;:�` My Comm. Expires Nov 27,2021 bonded through Nalanal NOWyAs+n ' of so PLANNING & DEVELOPMENT SERVICES ' - BUILDING & ZONING DIVISION 00 2300 VIRGINIA AVE RFcznBo FORT PIERCE, FL 34982 a *A I B 1p1 (772) 462-1553 FAX 462-1578 eS7t eDCpeam p 711 CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMT PLEASE SELECT ONE OF THE FOLLOWING: CHANGE OF CONTRACTOR — Change of Contractor is to be signed and notarized by the property owner, and the new contractor of record for the current permit. A new permit application must also be completed with new contractor information and signature. A new Notice of Commencement must be filed in the new contractor's name for job values greater than $2,500 ($7,500 if A/C Change -out). A recorded copy must be submitted prior to con encing any work. There is a $50.00 fee for the Change of Contractor. CHANGE OF SUBCONTRACTOR — Subcontractor changes are to be completed by the general contractor. The ew subcontractor must fill out a Subcontractor Agreement Form. There is a $50.00 fee for the Change of Sub - Contractor. CANCELLATION OF PERMIT — The cancellation of a permit is acceptable only if no work has been done. Cancellation of permit is to be signed and notarized by both the owner and qualifier of record. There is no fee for cancellation of the permit. Date: �A�'b' �2C Permit Number: _✓L� �g (� �3%S' SiteAddress: ?�J s C3(bk1.7 Jt0k sw ff Nt ICTJJ State License f�SLC License Original GC, subcontractor or owner/builder State License 1) O D, SLC License New GC, subwn actor r Reason for Cancellation The undersigned does hereb agree to indemnify and hold harmless St Lucie County, its officers, agents and employees from all costs, fees or damages arisi from any and all claims of action for any reason, which may arise as a result of this change of contractor/subcontractor or cQ1 lion of permit. A permit cannot be canceHY if work has been performed. S16WA7M OF OWNER (or o er)"��' �r SI A CONTR(AACI'Oi(or new GC,w applicable) PRINT NAME J j}p'�GS 7R 7ir1,1 �l� PRINTNAME I�r�t�•O �--� S`5� State of Florida, County of SL Lucie County ;RTK�—Whra g instnmentwas a7cA6_roVwledgVj16lore eatits is personally known to me or who ocad f � 2t� Signature of Notary Date State of Florida, Carty of$eL�eirlienty �rY.�,ro.r� The following instrument was acknowledged Mine tips r)�_d{ayyoff 20ALI by.C-TO wtro is personally known to me orwho duced as to SigmtureollNotatry Date tlt$1yo-Xo Revised 04/15/16 """' M ER ROSS '�° °�=otary Public" g:GG 194634'%;',�,�wl:�;,�°n Expires2D22 ""'•• SHIAINYAZDANI x•: Notary Pu6fc-Statc of Florida rh� Commission N GG 145540 `+•.� 11tt'4 •,Y. My Comm, Expires Nov 27,2021 ':: !!!!;'�� BantlM lhmugh NarmntNaluy Part