HomeMy WebLinkAboutSubcontractor i '77 2_(tbz,
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[PERMIT# AM_S--- ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
•
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
St.Lucie County Contractor Certification Number:
State of Florida Certification Number(if applicable):
I/ have agreed to be the
(Company NamelIndividual Name) r—
�� �� Sub-contractor for
(Type of Trade) (Primary Contractor)
For the project located at 11 1 a �_ &�u J
(Project Street Ad ess 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 filing a
Change of Sub-contractor notice.(Form: SLCCDV(No.004-00)
BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License)
NOTARIZED SIGNATURES ARE REQ IRED
Business Name: 13 6 f
.1, Stc
Address: w
City/State/Zip: �
Phone: L?07 email:
/w r to/,Ot//y
SIGN ATURE AME DATE
STATE OF FLORIDA, OUNTY OF M-C-4c,
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS 1�DAY OF 202
BY `� Z 0 WHO IS PERSONALLY KNOWN OR HAS
ASS IY (STAMP)
r C� �
'91GNAIrURE O TARY PUBLIC LORINT NAME OTARY PUBLIC
SLCPDS:1211612013
NANCY MIMS ARMSTRONG �
-•• . •: MY COMMISSION#EE059652',`
'+30 EXPIRES January 30,2015
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Oct 31 2014 09:47 HP FaxCentral MH E-33574850 page 1
PERMIT# ISSUE DATE
PLANNING.& DEVELOPMENT SERVICES
Building& Code Compliance Division
BtiILDING PERMIT
SUB-CONTRACTOR AGREENIEN T
St.Lucie County Contractor Certification Number:
State of Florida Certification Number(If applicable):
• hil-0have agreed to be the
(Company Name/Individual Name) �—
� Sub-contractor for I LlMaL
(Type of Tradc) (Primary Contractor)
For the project located at 113_ k
(Project Street Ad ess 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 filing a.
Change of Sub-contractor notice. (Form: SLCCDV(No.004-00)
BUSEUSS QUALIFIER (Name of the Individual shown on the Contractor's License)
NOTARIZED SIGNATURES ARE REQ D 1
Business Name: }� t�^ti P t�
Address: b k_)
City/State/Zip:
Phone: t(01 email:
At/I
SIGN TURE P AME DATE
STATE OF FLORiIDA, OUNTY OFEt THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS DAY OF .G.-' ,20-Y
BY .+r �, �1 l 7— Ck e'vck WHO IS PERSONALLY KNOWN OR HAS
,� N� � �r"/�.I►'Ie� (STAMP)
IGNA RE O TARY PUBLIC RINT NAME O NOTARY PUBLIC
SLCPDS:12/16/2013
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MY oo ON 9 E05965
,
gg ry 3012015
EXPIRES van
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