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ST. LUCIE COUNTY PUBLIC WORKS
BUILDING & ZONING DEPARTMENT
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number:
State of Florida Certification Number (if applicable): CooW C 0,3—/ 5-4,r6
cx o'WE ~e co_ a�tc. have agreed to be the
(Company Name/Individual Name)
/�%�G,yii7i✓LG,a� sub -contractor for eAOAvE /r'l�.y�/F,ycT�,�..� LP .r, e
(Type of Trade) (Primary Contractor)
for the project located at _ 7iy- ` X_ 47
(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)
ORIGINAL SIGirATtiRES ARE REQUIRED
I
SIGNATURE
Business Name:
Address:
City/State/Zip:
Phone:
,00;PvG W. C/z0k e /A/./z/oJ—
PRINT NAME DATE
if A 0 wE /1%i�i�ly�fic7y ei NG co. .rive.
13/
7"; � 7LV ,,/ ,, rG. x36D z
-./3) 0202 /— 619 7 9' email:
OFFICE USE ONLY:
PERMIT # ISSUE DATE