HomeMy WebLinkAboutSub-Contractor Agreement10/10/2003 08:27
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ST LUC1E COUFITY
PAGE 01/01
ST. LUCIE COUNTY PUBLIC WORKS
BUILDING & ZONING DEPARTMENT
BUELDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number:
State of Florida Certification Number (if appiiowe): d O / 3 gc' 3
6,0916 - Q l ^C % ledoo Cr U� have agreed to be the
(Company NameAndividual Name)
—sub-contractorfor D !TC L)f e k-
(Type ofTradc) (Primary Contracto
for the project located at —rr lqq f
(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)
OIUG_!� AL $[GNAT( -RE. ARE REQVIRED
SIGNATURE PRINT NAME DATE
Business Name: 6061 s N. Gr c _le.."la
Address: Oct, 1,v i�O.�CG/do2
Citylstatelzip: -. on L OC C- ;.r%
Phone: y 7 5- easail: _G/'bc (? I-C ���(5ac),,/, 1�w--
OFFICE USE ONLY:
PERMIT it ISSUE DATE
Oct 10 03 02c02p JA lQYLOR ROOFING 561,498 8397 P.1
ST. LUCIE COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
.BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number. a��CiC
State of Florida Certification Number (If applicable): C 13�51 d
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has agreed to be
(company/ind" in dui I name)
the �o ,_ �� A \ 6 ti
sub -contractor for ti crv-
-
( pe of construction trade) (name of the p ntractor)
for the project located at _�'+ra�.���,:. �o.:'t\ 3cv+�r1irr is understood that,
(street address or property tax ID #)
if there is any change of status regarding our participation with the above mentioned
project, I will immediately advise the Community Development Department (Growth
Management Division) of St. Lucie County by personally filc ing a Change of Contractor
Form (SLCCDV FORM NO. 004-00).
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BUSINPS AL ER (original signatures required):
C\" v,, of la ( �
re print name I date
business name:
address:
city,state.zip:
phone:
PERMIT X I
ISSUE DATE
SLCCDV FORM NO.: 002-00