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HomeMy WebLinkAboutSUB-CONTRACTOR SUMMARY�_ s ; •- —_ --- PLANNING & DEVELOPMENT SERVICES 1 BUILDING & CODE COMPLIANCE DIVISION o SceYNEO BUILDING PERMIT Sf j SUB -CONTRACTOR SUMMARY CUCtt? COUnti 117JLLrYI � /at/G will be using th` 1 11 sub -contractors for the (Company/Individual Name)(�lA ( i e �j project located (Street address 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 Plumbing FIVAC/ Mechanical Roofing Gas nS z i 1 e: c-ws 62 ,vs . Ga. 028�l�� ;r;.vc 9 OFFICE USE ONLY: PERMIT ISSUE DATE: NUMBERL PERMIT# ISSUE DATE —7 PLANNING & DEVELOPMENT SERVICES 0 Building & Code Compliance Division 0 0 - BUILDING PERMIT SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: # State of Florida Certification Number (ifappucable): *A W.f 400271av'T 'vlcaw � /A/6 • c10~ L-&:Xrr�� . have agreed to be the (Company Name/Individual Name) �lGiA15 Sub -contractor for &, n,,+ (Type of Trade) (Primary Contractor) For the project located at /90 3 5 E 2Wmo JaA0 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: SLCCDY (No. 004-00) BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License) NOTARIZED SIGNATURES ARE REQUIRED Business Name: Address: City/State/Zip: t /L4pZr&x i �LFo„te�yryt 3 fP A ne: ,SIOI S%j r70 20 email•S/�h/GT. doi� G _ ATURE PRINT NAME DATE STATE OF FLORIDA, COUNTY OF �a2d,yryp�QyE� �� QAC�Iti THE FOREGOING INSTRUMENT ,W'A,���IGNED BEFO"E THIS DAY OF �QY CAI"- 20A BY � ,1 0 k yy �• &-(4 t' �5 WHO 1S PERSONALLY KNOWN be' OR HAS PRODUCED SIGNATURE OF NOTARY PUBLIC SLCPDS: 12116/2013 AS IDENTIFICATION. �+ 4�2 ' t! L4Z� PRINT NAME OF NOTARY PUBLIC (STAMP) ••.,, SANDRA C. LEE ;p`~+P It Notary Public - State of Florida' y . • My Comm. Expires Apr 25, 2017 e;� Commission # FF 005521 Bonded Through WongWMAM PLANNING & DEVELOPMENT SERVICES DIVISION BUILDING & CODE REGULATIONS DMSION 2300 Virginia Ave Fort Pierce, FL 34982 BUILDING PERMIT SUB -CONTRACTOR SUMMARY FW f6Aw &✓j 1?oXd IJf S �L;i��k/FI will be using the following sub -contractors for the (Company/Individual Name) / � C project located at q4 15— (p b -3- — 0 U p i -- b n o — (Street address or Prope It is understood that if thereis 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 G.fn2LsNKrx. /!✓c . CABGsf 6G/3ooSs'/� Plumbing fN �— HVAC/ /CJ Mechanical Roofing Qv Gas /?/(.Q,SaN� 1tiaG�n-r4.d /SIG . OFFICE USE ONLY: PERMIT 1 ' ISSUE DATE: NUMBER: I �O2" O % 41 PERMIT # ISSUE DATE PLANNING & DEVELOPMENT SERVICES Building & Code Compliance Division BUILDING PERMIT SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: r]t 9 6S1 State fof""F'�lorida Certification Number (If applimble): 3 60 !M 7 V V I f2rtilL -t►xL have agreed to be the (Company Name/Individual Name) Y��//�l1 � / E�eGFfict� Sub -contractor for Co►�cep+t,r^I 1J2Siayy/�6trrusRr.ilKs (Type of Trade) (Primary Contractor) St j n s i 6r4�tius, ��c For the project located at 'I A_� — 6 0 1 ` 000 1 — 0 0G — (Project Street Address or Property Talc 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: SLCCDY (No. 004-00) BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License) NOTARIZED SIGNATURES ARE REQUIRED Business Name: Address: City/State/Zip: Phone: qG 6 -OS.Dv 4q0/, Ir— SIGNATURE PRINT NAME ` . DA E STATE OF FLORIDA, COUNTY OF C St Lu u-b THE FOREGGOING INSTRUMENT WAS SIGNED BEFORE ME THIS DAY OF �" LLG-r 20 t� BY Ivl%f b `�� l t �✓LP eLr� WHO IS PERSONALLY KNOWN _ZO R HAS IDENTIFICATION. l AA� ✓"! Vn � 4 nKirii� (STAMP) OF NO Y PUBLIC PRINT NAME OF NOTARY PUqLIC 12/16/2013 d'"r o '•6 .�+' �s, , LAUNIEC. SNYOER p Notary Public - State of Florida AGOMy Comm. Expires Aug 1. 2017 �'., rnmmlaeinn M rr OEr0E7