HomeMy WebLinkAboutSub-Contractor Agreement1
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGUIAnom DIVISION
D BU0(.DrNG rEi�nfrr
SUR-CONTRACTOR AGWWNI'
St. Lucie County Contractor CettMcaiion Number: !_ ! 6tzq
Staw o£FlaridEL C&tWcedoo Nmbox (tr•po=wo): F 000 3i 7 .
Ar-cu P,F't'TE G CT� I Cl�� COuTIC�ClIN6� 11V b$ve agreed to be the
(Co�ryNemte/bo�diviidual�Tmoote) -
��'� subcontractor for r camtnx& 10r)
{Type of Trade) (Priclary n
for the project located at �562s5aI-oo2z-a�� E
(Plojed Street Address or Property Tax ID #)
It is understood that, ifthem is any change of status regarding our participation with the
above mentioned project, I wW immediately advise the Building and Zoning Department
of St. Lucie County by personally Ming a Change of Contrador notice. (Fow SLCCDv
No. 00400)
BUSINESS QUALIFIER (Name of @te9fucliv &W shown on*e Cwnctas''s Lioeose)
OIOG SIGN 7
ARE REQUMED
SI ATURE kcApf-M
PTiIIVTNAME DATE
Businem" el� LFICI- 2 rCq CnW �"RArlrN6� »u C
Addtem ?Sod Gvllo Pc,
CwStan�ip: OXT S-r Lvc,E rL 3 qq Sol
Phoae: '77-. - 879` 7171 email: befftAsiai 9 ,qlr, AJET
OFFICE USE ONLY:
6 1 ISSUE DATE
ST. LUCIE COUNTY PUBLIC WORKS
BUILDING & ZONING DEPARTMENT
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number: I C0
State of Florida Certification Number (If applicable):
0-aim., -have agreed to be the
(Company Name/Individual Name)
sub -contractor for �-� (001W Ct1Gn
(Type of T a e) (Primary ontractor)
for the project located at L160 Z - 5 0 0 — QQ '2 Z _ d 00 _ k
(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 SIGNATURES ARE REQUIRED
�k f_�bec� Lu6�uw`
PRINT NAME
A46�rl-
Business Name:
Address:
DATE
City/State/Zip: �� C��� �,� . r' � Cam_ k�_ � 3 q ci � y
Phone: �171'D�� �3 email: \)C6XAk\_k
OFFICE USE ONLY:
L
PLANNING & DEVEL,OPNMNT SERVICES DAPARTMENT
$UILONG & CODE REGULAMNS DIVISION
BUELID NG FZMWr
SU-CONTRACTM AG NT
St. Lucie Cvuaty Contractor Cerdflcations Number: —
State of Flali& CaMcefien Nmbu atamliable): Gh C 05'a 13 LA
QlchCLO I have agreed to be the
(CarapmyNam ' u4N=q)
44 f (--C _ sub -contractor forMf i — -h CfN , LL 1—
(TypeofTrsaie).
for the project located at -
(Project Sheet Address or Property Tax ID 0)
It is understood that, if there is my change of status regarding Our participation wM the
above mentioned project, I will immediately advise the Building and Zoning Department
of St. Lucie County by personally llft a Change of Contractor notice. (Farm: SLCCDV
Na 0tF4-40)
BUSMSS QUATIMER(Nameoftbeyn&vidaalshmm(mthe'cmmcwsLicr=)
OMMAL SIGNATi1 ES APX REQT. MD
SIC A PF=NAW DATE
Business fie: l "U!
Addreism:
awst:
phene: -Z�
OMCE USE ONLY:
1RURDINiG & ZONINGDEPARTMMa
Y�J' L�'.
f f f t
SUB -CONTRACTOR AGM10EN
St. Lucas County Contractor CeztMeation Number, :57
State of Florida CmflA afion Ntmber Vf Vpnr bteY C
r'>jr,-yZe I2,0d;qyv
Nanael,Gmdivid
have agreed to be the
sub -contractor for67 ry
(Type;fT ) (pin► om toxj
for the project located at _ y s!0 2 -!'C) (3 ® -z2 - 40 a 0 - d
(ftoject Street Address or Property Tax lb #)
It is utzderstood that, if there is any clxango of status regarding our participation with the
above mentioned project, I will i=ediately advise the Building and Zoning Department
of St_ Lucie. County by personally Eding a Change of Contractor notice. (Fo= sLccDv
No_ 044-00) .
BUSIN S QUid LIMR (Name of the Individual shown on the Conuactoes LiccMe)
Q q11NAL S1A RESAPWREOUMED
o
f(3NATYIE MICT NAN E
$nsiness Name:
Address:
City/stateJ4:
.mane:
3 /r/-3 11V
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