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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):
IH1025264
QUALITY HOMES/DWIGHT DOUGLAS
have agreed to be the
(Company Name/Individual Name)
PLUMBING Sub -contractor for DWIGHT DOUGLAS
(Type of Trade)
For the project located at
(Primary Contractor)
4145 N US HWY LOT 48, FT PIERCE
(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 SIGNA
Business Name:
Address:
City/State/Zip:
Phone:
LAKELAND, FL 33810
863-608-2670 email: nancyarmstrong61@gmail.com
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PISTON'
DWIGHT DOUGLAS
PRINT NAME
03/08/2015
DATE
STATE OF FLORIDA, COUNTY OF POLK
J
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS 08 DAY OF MARCH , 2015
BY DWIGHT DO U G LAS WHO IS PERSONALLY KNOWN X OR HAS
PRODUCED FLDL AS IDENTIFICATION.
NANCY MIMS ARMSTRONG (STAMP)
SIGN TURF NOTARY PUBLIC PRINT NAME OF NOTARY PUBLIC
SLCPDS: 08/06/2014
NANCY MIMS ARMSTRONG
SION # FF19T899
MY COMMIS t0. 200
EXPIRES Febn►eN
Qr. 7 Flprfdallow
(407134
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACT] OORCA�GREEMENT
St. Lucie County Contractor Certification Number: 2L JV
State of Florida Certification Number (if applicable): c�'_M' l 44
�e_C�(Company Name/Individual Name)
1 L Sub -contractor for
(Type of Trade)
For the project located at
have agreed to be the
u��At4 ►�_ 4__mS
(Primary Contr ctor)
(Project Street Address or Property Tax ID #)
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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: 1C_
Address: 6
City/State/Zip: Z
Phone: —�Q�— email: ��' o
6y-n
SIG SURE PRINT NAME DATE
STATE OF FLORIDA, COUNTY OF
THE FO OING INSTRUMENT W S SIGNED BEFORE ME THIS DAY OF , 20��
BY ACWHO IS PERSONALLY KNOWN OR HAS
PRODUCED
AS IDENTIFICATION.
SIGNATURE OF NOTARY PUBLIC PRINT NAME OF NOTARY PUBLIC
SLCPDS: 08/06/2014
(STAMP)
IRENDA MARTINEZ
o4Pav P`A�%'
Notary Public - State of Florida
P? My Comm. Expires May 31, 2015
Commission # EE 98807
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