HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENT___'Ilium_ 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): CCU , 5O 1�-: I LA b
-F3_r' - ,� C'r n S� CA-1Cfn �C�1have agreed to be the
(Company Name/Individual Name)
(Type of Trade)
Sub -contractor for
(Primary Contractor)
For the project located at - D (03 S
(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: -`C�-� � C_'`nS-�-`C uC'V(0y-1 Ca
Address: Z ���6� PNFC--
City/State/Zip: � 3 7q_CQ 6
Phone: Z`Ai 'K email: \- � COY
GU
SIGNAT PRINT NAME DA•
ZYZC` C C
STATE OF FLORIDA, COUNTY OF
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS DAY OFC 20 �_
By a� Y \y (� �E-U WHO IS PERSONALLY KNOWN X OR HAS
AS IDENTIFICATION.
T
IGNATURE OF NOTARY PUBLIC f PST NAME OF NOTARY PUBLIC
SLCPDS: 08/06/2014
RENEE E EISWERTH
MY COMMISSION # GG016744
.','►Q, EXPIRES July 31, 2020
T_PR7T#
ISSUE DATE
PLANNING & DEVELOPMENT SE
RVICEs
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
U-vwupuny Name/individual Name)
the - ))Qcn101
(Type of Trade) Sub -contractor for
For the project located at j)Lo- C
have agreed to be
LaVJ S
(Primary Contractor)
I e-r-no 'V-c�
(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, the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the
filing of a Change of Sub -contractor notice.
CONTRA TO IGNATURE (Qualifier)
PRINT NAME
26K-7X
COUNTY CERTIFICATION NUMH
State ofFloridn, County of
The foregoing instrument was signed before me this 1
day of
t_.)LC�' i YL�'JCV,20-D by
who is personally Muwnk or has produced a
�, as'dentifcation.
S gnnturc of Notary Pubbc STAMP
Print Name of Notary Public
RENEE-E EISWERTH
-
Revised ] 1/16/2016 = MY COMMISSION # GG016744
-
'?+ EXPIRES July 31, 2020
R SIGNA'rURL (Qualilicr)
PRINT NAME
GCS ZC5
COUNTY CERTIFICATION NUMBER
------
State of Florida, County of F- L
The foregoing instrument was signed before me tills , day of
D2Le rnY�,� 20 1 by SC�-m,eS SU1csmS�+-�
who is personally known X or has produced a
as identification,
STAMP
Signature of Notary Pub][c
/
Print Name of Notary PUbitc
RENEE E EISWERTH i
=•/ •_? MY COMMISSION # GG016744
'�"' EXPIRES July 31, 2020
PERMIT# ISSUE DATE
PLANNING & DEVELOPM[ENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number: • W, (_0 0 �
State of Florida Certification Number (If applicable):
ca's� E \-e c--V rC have agreed to be the.
(Company Name/Individual Name)
-e-1-e C_ -Y '� c Sub -contractor for LU J s
(Type of Trade) (Primary Contractor)
For the project located at LQ d
(Project Street.
e.�
or Property Tax ID #)
�V
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 SLGNATURES ARE RCEQUIRED`
Business Name:
Address:
City/State/Zip: U � e 1P
Phone: �} 1 Z - C — q� ��j email:
SIGNATURE PRINT NAME DATE
STATE OF FLORIDA, COUNTY OF
THE FOREGOING INSTRUMENTWAS SIGNED BEFORE ME THIS DAY OF L--�=b�r .20
BY 31D 5 WHO IS PERSONALLY KNOWN '--' OR HAS
PRODUCED
SIGNATURE OF NOTARY PUBLIC
AS IDENTIFICATION.
PRINT NAME OF NOTARY
(STAMP)
SLCPDS:, 08/06/2014
RENEE E EISWERTH
? MY COMMISSION # G0016744
y' �¢= EXPIRES July 31. 2020