HomeMy WebLinkAboutSub-Contractor AgrrementN.r
PERMIT# 16 ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number: 1 0
State of Florida Certification Number (if applicable): C-r.0-0 :S-tsa co
have agreed to be the
(Company Name/Individual Name) jj
PW ��, t � C� _Sub -contractor for �'70�! ��-�z-i"� ,�a�t�
(Type of Trade) (Primary Contractor)
For the project located at /070 / '"- N bQi 4A�
(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: _
L
email: UQ C� 1 P. 10� M. _Z-ero 'Gd wl
DATE
• R P T NAME
STATE OF FLORIDA, COUNTY OF � i � �
14
FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS J' " DAl' OF / 20
BY � WHO IS PERSONALLY KNOWN OR HAS
PRODUCED
rl
k 1 I - — lav 4
►1�
SLCPDS: 12/16/2013
AS IDENTIFICATION.
NAME OF NOTARY
(STAMP)
RHONDA LAFFERTY
MY COMMISSION # EE854297
EXPIRES January 08. 2017