HomeMy WebLinkAboutSub-Contractor AgreementRECEI`.'�D NOT`_", 1016
S
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):
Q d
I Ke-V ►n s�
have agreed to be the
(Company Name/Individual Name) t
ky N- CG.\ Sub -contractor for Go, `& qn LoQ (Type of of Trade) rimary Contractor)
For the project located at
(Project Street Address or Property Tax
k--51
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:
Address:
City/State/Zip:
Phone: �'—1 D�o9 emailrQCle4s'PAe,C.�'l�iC,CA`S24'4iCeS®��G•\.
GNATURE PRINT NAME DATE
STATE OF FLORIDA, COUNTY OF
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS_ DAY OFF pro b er , 201
BY WHO IS PERSONALLY KNOWN OR HAS
PRODUCED ` �0 AS IDENTIFICATION.
(STAMP)
SIGNATURE OF NOTARY PUBLIC PRINT NAME& NOTATY PUIILIC
SLCPDS: 08/06/2014 ig`"n4 Notary public State of Florida
® Angie Bryant
%9oa My Commission FF 163371
.1I Expires 09/25/2018