HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENTPERMIT # I I � O � _ I ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR/ AGREEMENT
St. Lucie County Contractor Certification Number: 2 o 6 7
State of Florida Certification Number (If applicable): �� o on
D <2 15 ����/ d � zS-have agreed to be the
(Company Name/Individual Name)
/ Sub -contractor for
of Trade
(Type ) (Primary Contractor)
For the project located at
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: ITJ es rlee-tr/e-7- 0 ( Yr/ 1, C /
Address: �S % Lei C. C', v, AL
City/State/Zip: �% v�/G� vE-1 I -? 5 � jF_-4
Phone: 77.E .2363 email: 'l
�9,v, ;1. 1 11�7 dl6,,, < , 7 -J- 9- -/!Z
/Y,-"NATtJRE PRINT NAME DATE
STATE OF FLORIDA, COUNTY OF
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS c)(9_ DAY O , 20ILI
BY 3L)�.QV-, "-p f y S WHO IS PERSONALLY KNOWN OR HAS
PRODUCED 1, "�V-O-, L C_ S2 4. S Q AS IDENTIFICATION.
'a�X &�o I i �TU11)FOF
(STAMP)
NO AR�PL��C� PRINT NAME OF NOTARY PUBLIC
_ 3LCYDS:12/16/2013
r- -
"� o " Notary Public State
of Florida
Rebecca M Moll
My Commission EE038978
Expires 11/01/2014
PERMIT # ISSUE DATE
�Jr PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
s o
BUILDING PERNIIT
SUB -CONTRACTOR AGRFF.MMNT
St. Lucie County Contractor Certification Number. nqd 7.0
State of Florida Certification Number (ifamiimbie): C �� D li jD 616,
have agreed to be the
(Company Name/IndividualSame) ?
Sub -contractor for
(Type of T e) (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 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 ofthe Individual shown on the Contractor's License)
NOTARIZED SIGNATURES ARE REQUIRED
Business Name:b,J,e�
Address: %L Saco o s� f
City/State/Zip: �- l�Gprlce. 5A1J,rC-;,' p �/
Phone: 7' sls0_J 71 email:
J —�—
SIG PRI
% NAM
/E j DATE
STATE OF FLORIDA, COUNTY OF 5
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS DAY OF 20y