HomeMy WebLinkAboutChange Of Sub-ContractorCOUNTY°•
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
Building and Code Regulations Division
BUILDING PERMIT
CHANGE OF SUB -CONTRACTOR AGREEMENT
I, 1208f l , am requesting a change of sub -contractor
Main Qualifier Name
From AZ` 5`ToIEV, PLvJmaI0& to the new contractor listed below.
Existing Sub -Contractor Name
New Sub Contractor Information:
St. Lucie County Contractor Certification Number: lD o
State of Florida Certification Number (If applicable):
P�QQA b 1M g.��d P_S W1JM1 Rl P6- yrcr 2C'J _ have agreed to be the
(Company Name/Individual Name)
PL'V.ti3iNC:,- Sub-contractorfor A0146C,40A0.Si -
(Type of Trade) (Primary Contractor)
for the project located at 1 S - d � aau'4 (04-4 k' ''` �,�L 3� 7s, 7
(Project Street Address or Property Tax ID #)
BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License)
Business Name:
��(!���1s1il�Ill��1�_►1"lw1�iB�l��t�a�� v.��.�i
City/State/Zip: 1 61 �
01
STATE OF FLORIDA, COUNTY OF .� -
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS o+�- DAY OF MQ✓iC..I4
BY CT �U10.1 INS WHO IS PERSONALLY KNOWN � OR HAS PRODUCED
4. RHONDA LAFFERTY
AS IDENTIFICATION. 41 a*:= MY COMI�j�SII I EE854297
EXPIRE+S� Janus 08, 2017
•0153 FbridallotaryService.com
SIGNATURE OF NOT PUBLICP INTNAME OF NOTAR PUBLIC
nmrF, nw. ONLY:
PERMIT # ISSUE DATE
CPS: 11-27-2013