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HomeMy WebLinkAboutSub-Contractor Agreement04/14/2008 08:19 7724621_R7'A-_ To I PAGE 01 ' ST.LUCMC4 )BUMDING & UXUDING PnMr SUB-CONTRACTORAGUEMNT St- LVCiC CblMty COWMCtOr Certification Number -�11 State of Florida Cer4dca6en Mini= (Ifawlicabl,); U—C, have agreed to be the, _Z419mY Narne/(ndividual Name) sub -contractor fofz1:_ (Type of Trade) - I I (Primary. for the prof cct located at LAt,3 LJ - F -, - +), (Project Street Address br Property Twl 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 c ._,e of Contractor notice. (Form. SLCCDV No. 004-00) BUSINESS QUALMER (Name of the Individual shown on the Contractor's License) -OFJGhNAL S1Giv RES ARE UIRED OL FRJNTNAME DATE Business Name: F Address: n n 0 te in U city/statOzip: Zxhn. .Phone: OFFICE USE ONLY: • C� PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION BUILDING PERMF SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number.. State of Florida Certification Number (ifapplicable): tvt clga pn,,� 'I t4Q,1 C �e C c S have agreed to be the (Company Nkme/I/Inndividual Name) mac- 2 i c J sub -contractor for �b , Q COo c, Co nsk ('uc. vil- (Type of Trade) (Primary Contractor) for the project located at tq j 1' -- QIe ag- it (Project Street Addrogs 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 a. CA'm'A'i - SIGNATURE NAME ff - n DA Business Name: e n.. r % on, CST 2� CA se fv lCQ$ Address: 10'M 6V�Z W L P me, City/State/zip: '9a at-- , it 3 4q4 q Phone: 17'1z- Z85-1380 email: &JArV10A&o#%-%av1 ti a a01• cvM OFFICE USE ONLY: