HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENT ROOFINGPERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
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)J J
noil►nQ Sub-contractorfor
(Type of Trad (Primary Contractor)
For the project located at q sb,+
(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: S_'_H Coo
Phone: �'$.t 5�s - 8 a email: CS1r,1 eual i y o-e
Ct►'ld � vr► SI7-��t'7
SIGNATURE PRINT N V [E DATE
STATE OF FLORIDA, COUNTY OF ice- o m TJCa Cy(
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS 2.3 DAY OF V`elau , 2017—
BY 1_vnd(� 12'U Y, l no WHO IS PERSONALLY KNOWN OR HAS
PRODUCED
az%_" No� AAzzy\_
SIGNATURE 000A Y PUBLIC
SLCPDS: 08/06/2014
AS IDENTIFICATION.
RShIc- u _�ohrvso n
PRINT NAME,9F NOTARY PUBLIC
(STAMP)
Ashley Johnson
COMMISSION # FF196256
EXPIRES: February 4, 2019
www.AARoNNOTARY.COM