HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENTST. LUCIE COUNTY PUBLIC WORKS
BUILDING & ZONING DEPARTMENT
B LDING PERMIT
SUB -CON RACTOR AGREEMENT
1 7 . .
St. Lucie County Contractor Certification N mber:
State of Florida Certification Number (If appI I able): ccc a
T., c, have agreed to be the
(Company Name/I�dividual Namej q
Q46 � I tA 4 sub -co tractorfor 7R_,rV7C,1&+.CT-. /^rc-.
(Type oftrade) (Primary Contra'ctor)
for the project located at 3250 ',A41,ov�w-RiAL 33"r1i(2e--702_-1'192�6
(Projec Street Address or Property Tax ID
It is understood that, if there is any hange of status regarding our participation with the
above mentioned project, I will im ediately advise the Building and Zoning Department
of St. Lucie County by personally #ling a Change of Contractor notice. (Form: SLCCDV
No. 004-00)
BUSINESS QUALIFIER
SIGNA
P
SI7ATURE -
Business Name:
Address: Q
City/State/Zip:
Phone:
OFFICE USE ONLY:
of the Individual shown on the Contractor's License)
IV P 1) elu�,5"rj&)
PRINT NAMP, VDE
Cooalfs /?JLd
k4ova-,_ i=1 ' ?-? 01
a 414 6 email: