HomeMy WebLinkAboutSub-Contractor Agreement�.,� PLANNING & DEVELOPMENT SERVICES
Building, & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number:
State of Florida Certification Number
(Type of Trade)
For the project located at
Sub -contractor for
(Primary Contractor)
74 e ®d�%/
(Project Street Address or Property Tax ID #)
have agreed to be the
P s /L .
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: SLCCnV (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:
email:
SIG ATURE PRIAT NAME DATE
STATE OF FLORIDA, COUNTY OF
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS RDAY OF 20�""'
BY\��l , /" \ C�Lu\-P, WHO IS PERSONALLY KNOWN OR HAS
PRODUCED J_ Z_ A--) AS IDENTIFICATION.
'(STAMP)
UUU
SIGNATURE OF N TARY PUBLIC P T NAME OF NOT Y PUBLIC
SLCPDS:12/16/2013