HomeMy WebLinkAboutSubcontractor Summary and Subcontractor Agreement PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
SFL084
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
St.Lucie County Contractor Certification Number: 9?.3 3 , Q
State of Florida Certification Number(if applicable): EC13005265
CSI COMMUNICATIONS INC. have agreed to be the
(Company Name/Individual Name)
ELECTRICAL Sub-contractor for RUSSELL S. NATTRASS
(Type of Trade) (Primary Contractor)
For the project located at 524 S. MARKET AVE. FT. PIERCE, FL 34982
(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
D
Business Name: '441
Address: 4100 N. POWERLINE ROAD SUITE X1
City/State/Zip: POMPANO BEACH, FL 33073
Phone: 954-854-9863 email: dolores.alcantara@civilsolutionsne.com
BENNY A. GORDILS
4,�� Zli
SIGNATURE PRINT NAME DATE
STATE OF FLORIDA,COUNTY OF BROWARD
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS DAY OF ,20
BY BENNY A. GORDILS WHO IS PERSONALLY KNOWN X OR HAS
PRODUCED AS IDENTIFICATION.
Sheryl Peters (STAMP)
SI ATURE OF OTARY PUBLIC PRINT NAME OF NOTARY PUBLIC'
u SHERYL PETERS
SLCPDS: 08/0 14 ,.moo``"a °';
Notary Public State of Florida
_ , •_ My Comm.Expires Mar 21,2017
Commission# FF 001615
Bonded Through National Notary Assn:
S �J
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
® a, Building and Code Regulations Division
BUILDING PERMIT
SUB-CONTRACTOR SUMMARY
CSI COMMUNICATIONS INC. will be using the following sub-contractors for the
(Company/Individual Name)
project located at 324 S. MARKET AVE. FT PIERCE, FL 34982
(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.
St.Lucie County/
Trade Name of Company/Contractor State of Florida
License Number
Electrical CSI COMMUNICATIONS INC. EC13005265
BENNY A.GORDILS
Plumbing
HVAC/
Mechanical
Roofing
Gas
OFFICE USE ONLY:
PERMIT ISSUE DATE:
NUMBER:
Revised 07/29/2014