HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENTSGANNtu
ST LUM 00LIN'rV
�9 ST. LUCIE COUNTY PUBLIC WORKS
BUILDING & ZONING DEPARTMENT
�ORI�p'
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number: �� _ � 7
State of Florida Certification Number (If applicable): 000 f (0 2
eC iLcY te55 have agreed to be the
(Company Name/Indivi al Name)
�! 4-23L sub -contractor for
(Type of Trade) (Primary Contractor)
for the project located at A-1 ` Nc.�, Iz- 05�6 s ; \ e L
(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
SIGNATdIU PRINT NAME
Business Name:
Address:
City/State/Zip:
Phone:
1p� email:
OFFICE USE ONLY:
PERMIT # ISSUE DATE
2- 1 -0(e
DATE