HomeMy WebLinkAboutSub-Contractor AgreementPERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division.
o
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) .
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.paiticipation 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: 1;��y y(\.��
Address: \o3iJa:\e�Wcc�
City/State/Zip:. N-) S.L _
Phone �1a -a�3-�q`l� email:
SIGNATURE PRINT NAME DATE
STATE OF FLORIDA, COUNTY OF
THE FOREGOING INSTRUMENT WASSIGNED. BEFORE ME THIS DAY OF
BY RczO ate, V� ��KK�Ow�k�Y WHO:IS PERSONALLY -KNOWN iHAS
PRODUCED AS IDENTIFICATION:
SIGNATURE OF NOTARY PUBLIC
SLCPDS: 08/00014
(STAMP).
PRINT NAME OF NOTARY PUBLIC
a�ti,�, ' STELLA M. HUNTER
�y Notary popllo . Shfe of FIN
• Commisilon # FF 100652
Sr, My.Comm. Explres.Jxn,
.,re.. rT3, 2010 .
PERMIT # ISSUE DATE
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'SIGNATU{�RES.ARE REQUIRED