HomeMy WebLinkAboutSub-Contractor AgreementG ST. LUCIE COUNTY PUBLIC WORKS
ti BUILDING &ZONING DEPARTMENT
F�ORI�A
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number:
State of Florida Certification Kumber (If applicable):
have agreed to be the
(Company Name/Iridvdual Narrie)
—" _
sub-contractor.for
(Type of Trade) (Primary Contractor)
for the project located at
(Project,Sireet 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 personally filing a Change of Contractor notice. (Form: SLCCDV
No. 004-00)
BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License)
ORIGINAL SIGNATURES ARE -REQUIRED
tj
SIGNATURE PRINT NAME DATE
Business Name:
Address:
City/State/Zip:
Phone: i
;r
OFFICE USE ONLY:
PERMIT #
email:
ST.-LUCIE COUNTY PUBLIC WORKS
" y BUILDING & ZONING DEPARTMENT
. F�OR1�P
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number:
State of Florida Certification Number (if applicable)_
.� have agreed to be the
(Company Name/IndividualHame)
sub -contractor for
(Type of e) (Primary Contractor)
for the project located at q a0�Qa (A,
(Project-:! r ehAddress 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 personally filing a Change of Contractor notice. (Form: SLCCDV
No: 004-00)
BUSINESS'QUALIFIER (Name of the Individual shown on the Contractor's License)
ORIGINAL SIGNATURES ARE REQUIRED
V 0,\ R 4Q:y c)
SIGNATURE PRINT NAME DATE A E
Business Name:
Address:
City/State/Zip:
Phone:
OFFICE USE ONLY:
PERMIT 4 ISSUE DATE