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HomeMy WebLinkAboutSub-Contractor AgreementJo11 CO 00 Ou. top. _ J , ST. LUC:IE COLNTX pY1BLIC WORKS 0 YMILDING & ZONING)DEPARTMENT 13UILDING.PEHMIT SUB-CON•rRACTOR AGT21?.EMrNr 5t. I.ticic County Contractor Certification Number: _ c2 D7 7 �y State of Florida Certification Nu i ber grapplicable): ! (� ` ���°?��__ have agreed to be Lae (Co pany Narue(indtvi tial sub -Name) —t►�` I contractor" or j (Type of Trade) (Primary Contractor) for the ' project Located at (Project Street [iddtess or Property Tax It)`#)• It is understood that, if the re, any change 0Fstatus regarding our participation with the above mentioned project, 1 will immediately advise the Building and 'Coning Department of St. Lucie County by personally filing a Change of Contractor notice. (Dorm: SLCCi)y No. 004-00) BUSINESS QIJALI]FzER (Name of the Individual shown on the Contractor's Liccn ,e) rn SIGNA'IUI{!v LRINTNAME DA Business Narnc:`j'Z�—�, Address: _—"�� ©, �0► (1.IJi?1f 4✓'U� —. City/State/Zip:... F1 "''� Q lo.� 777 .Phone: email: n J ` G ST. LUCIE COUNTY PUBLIC WORKS BUILDING & ZONING DEPARTMENT �OR1�P BUILDING PERMIT SUB -CONTRACTOR AGREEMENT St. Lucie' County Contractor Certification Number: 191 0 4 State of Florida Certification Number (If applicable): CPC 057200 A & G CONCRETE ' POOLS have agreed to be the (Company Name/Individual Name) PLUMBING sub -contractor for A & G CONCRETE POOLS (Type of Trade) (Primary Contractor) 4nw_�OL for the project located at S3o� �Gad (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_ 004700) BUSINESS QUALIFIER (Name. of the Individual -shown on the Contractor's License) ORIGINAL SIGNATURES ARE REQUIRED ARTHUR ALLEN SIGNAT PRINT NAME Business Name: A & G CONCRETE POOLS Address: 410 SAEGER AVENUE City/State/Zip: FORT PIERCE, FL 34982 Phone: 878= 7752 email: i OFFICE USE ONLY: PERMIT # ISSUE DATE DATE