HomeMy WebLinkAbout1306-0321 SUB-CONTRACTOR AGREEMENTMing.a-Change of Contractor notice. (Form: SLCCDV
on the Contractor's: License)
PRINTNAME DAT
S$ Lueib C®unh/
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o �
St Lucie County Contractor
State ofFlorida Certification
a &-s
(Company Narndlh
.
(Type of Trade)
%4WG &-DEVELOPMENT SERVICESDEPARTMENT
BUILDING &: CODE REGULATIONS DMSION '
BUILDING PERMIT
SOB -CONTRACTOR AGREEMENT '
ification Numher. -
ttber (Ifwjimble): ODO
have agreed to be the
ival N&ne)-
a suticontractor`foi•
I (PrimaryContractor)'
for the project located at
�jacez
Property Tax ID #)
It is understood that, ifthere is<any changeof-status regarding our participation with the
above mentioned project, I>will:immediately advise the Building and.Zoning Department
of St. Lucie County by:
No. 004-00)
BUSINESS QUALIFIER
ORIGINAL SIGNATURE,S AR
Business Name:
Address:
Citylstatex1p:
Phone:
OFFICE USE:
I
IPLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
BUILDING PERMIT
a SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number: �5C
State of Florida Certificati Ion Number (If applicable):i"l +nA��
TC,1 rj n,jyy have agreed to be the
(Company Name/Individual Name)
sub -contractor for A v-G Can wJt 1 o4s
(Type of Trade) —),(Primary Contractor)
for the project located at oslA`"I
(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. .Lucid. 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
aryries�f'
PRINT NAME
Business Name:
Address:
City/State/Zip:
Phone:
OFFICE USE ONLY:
PERMIT # ISSUE DATE
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DATE
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