HomeMy WebLinkAboutSub-Contractor AgreementPERMIT # ISSUE DATE
PLANNING & DEVELOPMENT -SERVICES
a� Building & .Code Compliance Division .
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St.' Lucie County Contractor Certification Number: %Z 13052 5 5s7
State of Florida Certification Number (If applicable):
have agreed to be the
(Company. Narre/Individual Name) .
Sub -contractor for
(Type of Trade).. (Primary Contractor)
For the projectlocated at \O`"`'a S �C23�•c��,. �2�S2C .
(Project Street Addressor Property Tax ID #)
It is understood that, ff 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 -contactor notice. (Form: SLCCDV (No. 004-00)'
BUSINESS QUALIFIER .(Name of the Individual shown on the Contractor's License)
NOTARIZED SIGNATURES ARE REQUIRED
Business Name:�QZ
Address: �h'3 o'l \2C
City/State/Zip:
Phone: email:
. B�.Jizs R
SIGNATURE PRINT NAME DATE
STATE OF FLORIDA, COUNTY OF
THE FOREGOING INSTR-UMENT.WAS.SIGNED BEFORE. ME THIS Zo DAY OF uR , 20 %S
BY \l'` �� `1E�t�Ow a��C_ WHO. IS PERSONALLY:KNOWN L OR HAS
PRODUCED AS IDENTIFICATION:
(STAMP).
SIGNATURE. OF NOTARY PUBLIC PRINT NAME OF NOTARY PUBLIC
SLCPDS: 08/06/2014 r'� . S ' • :.
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STELLA M. HUNTER
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PERMIT # ISSUE DATE
STELLA M. HUNTER
° .`��•,
Notary PubliC r State of Florida-
e
Commission # FF 180552
of
•age �•``
My Comm. Expires Jan 23, 2019
Bonded through National Notary Assn.
PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
C Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT . .
St. Lucie County Contractor. Certification Number:
State of Florida Certification Number (if applicable):
�e_ q have agreed to be the
(Company Name/Individual Name)
Sub-contractor for 'eA�,
(Type of Trade). (Primary Contractor)
For the project located at
(Project Street Addressor 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:
1 u )14U Ott n
SIGNATURE
PRINT NAME V DATE
STATE OF FLORIDA,. COUNTY OF.
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE. ME THIS a 1 DAY OF
.BY, � k �(� C ��R11� C� `(��-�
WHO IS PERSONALLY:KNOWN _ -6R HAS
PRODUCED
AS IDENTIFICATION,_
.(STAMP)
SIGNATURE OF NOTARY PUBLIC
PRINT NAME; OF NOTARY PUBLIC
SLCPDS: 08/06/2014
,,.�u, STELIA M. HUNTER .
Notary Public - State of Florida
41 ;= Commission # FF 180552
My Comm. Expires. Jan 23- 2019
•�„' . .Bondedthkx*NaiimWNotary Assn.