HomeMy WebLinkAboutSub-Contractor AgreementST. LUCIE COUNTY PUBLIC WORKS
BUILDING-& ZONING DEPARTMENT
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BUILDING PFaMT
SUB -CONTRACTOR -AGREEMENT
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St. Lucie County Contractor Certification Number: d
State of Florida Certification Number (Wapplicable): / 3 6 / s-O %
have agreed to be the
(CompanyName&dividual Name)
G7ruCl�- L sub -contractor for % d
(Type of Trade) (Primary -Contractor)
for the project located at -2,&�2, 7 AJ u S / ,f—, f PrCle g ®JF" '�
(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)
BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License)
ORTGMAL SIGNATURES ARE REQUIRED
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SIGNATURE P . T NAME DATE
Business Name: lJ A ^0 �T `L C .- a 7"r..4 Clk-t-
Address: SE S Ztet.�no-
City/State/Zip: r Zit e c Q 3 V5A3
Phone: 272—R%A-50017'L email: 6' ✓/ ¢ L-Cold
OFFICE USE ONLY:
ST. LUCIE COUNTY PUBLIC WORKS
BUILDING & ZONING DEPARTMENT
. F�ORIOQ'•
BUILDING PERMIT
SUB-CON11UCTOR AGREEMENT
St. Lucie County Contractor Certification Number: a
State of Florida Certification Number (If applicable): dd 0 F 7 9'
6r0 t. t,, (� 3 have agreed to be the
(Company Name/Individual Name)
rr f l� �
Amn_
sub -contractor for / Uv�'t
(Type of lade) (Primary Contractor); - .
for the project located at ACo d`Z % /U. lids 14w V % �—' i. A er-cC Z o
(Project Street Address orPropelty Tax fD#/)
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
8I(s�NATIJRE /O �► ` �� �^ �� _ J
l D
PRINT NAME DA
Business Name: O Li P1 4-
Address: SD ' 7 1 C-' ,-
City/State0p: Cam. + .� t [lp g •'y (�
email -
Phone: 3 �,� yoZ 7 &0 5-7
OFFICE USE ONLY:
/ �tl J I - �.
�y ST. LUCIE COUNTY PUBLIC WORKS
• BUILDING & ZONING DEPARTMENT
�oRtioA
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number.
State of Florida Certification Number (iifapplicable): C 1rF! 5
/ A� C ' have agreed to be the
(Company Name/Individual Name)
a"pt (01 'a sub -contractor for &9 w rt I Q of hu'n
(Type of Trade) (Primary Contractor)
for the project located at S 6J#!4 rr4 •q.e,ree, ( 31 i y (p
(Project Street Address or Propefty 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
IGNATUI2E PRINT NAME ' DAT
Business Name:
Address:
City/State/Zip:
Phone:
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