HomeMy WebLinkAboutSub-Contractor AgreementPERMIT # 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):
have agreed to be the.
(Company. Name/Individual Name)
Q� Sub -contractor for
(Type of Trade) (Primary Contractor)
For the project located at
(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 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 REQUIRED
Business Name:
Address:
City/State/Zip:
Phone: '�`174 — 01 �3 =3��g email:
�—QL
DATE
STATE OF n6mDA,, COUNTY OF \-C\ (a s1
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS � DAY OF ��C\ , 20�
BY
PRODUCED
.i-
SIGNATURE OF NOTARY PUBLIC
SLCPDS: 1246/2013
motary Public - State of Florida
Commission •# EE 31278
Bonded Through National Notary Assn.
PRINT NAME OF NOTARY PUBLIC
KNOWN z10R HAS
(STAMP)
PERMIT # 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):
S C> e N W\ cr c�vc� have agreed to be the
(Company Name/Individual Name)
Sub -contractor for VeQ) .�s�
(Type of Trade) - (Primary Contractor) .
Forthe project located at
(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 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 REQUIRED
Business Name:
Address: S�,z
City/State/Zip:
Phone:�3�- email:
Age
SIGNATURE PRINT NAME DATE
STATE OF FLORIDA; � COUNTY OF �c nk C---,
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS DAY OF C1 , 20A
BYWHO IS PERSONALLY.KNOWN FOR HAS
PRODUCED AS IDENTIFICATION.
SIGNATURE OF NOTARY PUBLIC
SLCPDS: 12/16/2013,
PRINT NAME OF NOTARY
STELLA M(18tp)
"otary Puhlic - State 61 Floric;
My Comm E.xPires Jan 23, 2(
Commission # EE 31278
Bonded Through National Notary k
PERMIT # 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):
( cl\ have agreed to be the
(Company Name/I idual Name) �^
\A {J Sub -contractor for
(Type of Trade) (Primary Contractor)
For the, project located at
(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 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 REQUIRED
Business Name:
Address:
City/State/Zip:
Phone:
email:
9IGNAWRE fRIWNAME DATE
STATE OF FLORIDA, COUNTY OF F !\
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS a Z DAY OF 20.
WHO IS PERSONALLY KNOWN OR HAS
PRODUCED AS IDENTIFICATION.
(STAMP)
SIGNATURE OF NOTARY PUBLIC
SLCPDS• 12/16/2013 rr°. .R� "rotary Public -,State of Florida
. • c My. Comm. Expires Jan 23, 2015
Commission # EE 31278
•' %° �� ��`�` Bonded Through National Notary Assn.