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HomeMy WebLinkAboutSub-Contractor AgreementST. LUCIE COUNTY PUBLIC WORKS BUILDING & ZONING DEPARTMENT BUILDING PERMIT SUB --CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: d 5/ State of Florida Certification Number (If applicable): C/T- &4-5,r k c have agreed to be -the (Company Name/Individual Name) , sub -contractor for S 4 'r (Type of Trade) ' (Primary Contractor) for the project located at 3� 4e- �-1z kq cat -e (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 personally filing a Change of Contractor notice. (Form: SLCCDV No. 004-00) . 0 BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License) ®RIGLN1 A IGtiATllRES ARE REQUIRED Jo WTE SIG A PRINT NAME Bu " ess Name:`¢ C Address: City/State/Zip: Phone: 77-o OFFICE USE ONLY: 1�, t3 �� email: �y ST. LUCIE COUNTY PUBLIC WORKS BUILDING & ZONING DEPARTMENT �OR10 BUILDING PERMIT SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: State ofFlorida Certification Number (if applicable): 2� 1145 0 ce) SL I _ c j4s P tqc_irL 7' have agreed to be the (Company Name/Individual Name) i sub -contractor for X tjw Ro (T a of e) (Primary Contractor) for the project located at 1op�oGr q /9 t 0 M -4 (Project Street Address or Property Tax ID #) ®�®� /q30- )®.:�_D60 It is understood that, if there is any change of status regarding our participation with the PLO 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 /Al 110 - 6 net4�. kb* z, _&6 4,4-r- G NATURE PRINT NAME DA E Business Name: i (r /C7 00v t 41 / "� � ioz c Address: City/State/Zip: Phone: __--> %;z i/G —x16 OFFICE USE ONLY: email: A J.J. ELOISE CUMINGS Y COMMISSION #00874307 IRES: APR 06, 2013 ndedthrough 1stStffie Insurance � PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION BUR DING PERMIT SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: State of Florida Certification Number ¢fapplicable): C Pfc d 3� �+ (o!1 p aV a i \+ e— ; vy\ have agreed to be the (Company'Rame/Individual Name) R% r Cy vt aoo u n c,,> sub -contractor for ► S r` s rh b n'& 1- L o m g T (Type of Trade) (Primary Contractor) for the project located at 5�� �� gr� L4R p� V + �b �r«J (Project Street Address or Property Tix ID #) 3 T 11 9 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 IGNATURE _ ,PRINT.NDATE o OPs�''1;� Business Name: Address: � City/StateJZip: Phone: Ail°1ri-lN, Al H6i._1 of the i +F EASURE COAST: INC. : 1 n it CT FORT PIERCE, FL 34982 ` Llj— L JL5 - } L v ko email: I1Ti i ird-ly 7TQ7'i A1%TF .V- Vl'.L'ivJJ vA7-• va�ar+ PERMIT# ISSUE DATE