HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENT 12-23-15PERMIT # 1i S�fo (0 —. CS-30 ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT 1� ��Q�
SUB -CONTRACTOR AGREEMENT i
St. Lucie County Contractor Certification Number: O�� ��� �A i'Sut�� �.,:,zCm,,
�Y i�79�.eC�V+ oP�6i�FC='"
State of Florida Certification Number (If applicable): 1
(Company Name/Individual Name)
(Type of Trade)
For the project located at %\\o
(Project Street
have agreed to be the
for 1 ,),- 4P.�
(Primary Contractor)
S ! 1, %&
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)
i
BUSINESS QUALIFIER (Name of the individual shown on the Contractor's License)
NOTARIZED SIGNATURES ARE REQUIRED
Business Name:
Address:
City/State/Zip:
Phone:
11a -y66 -D363
PRINT
N3-a3-SE)
DATE
STATE OF FLORIDA, COUNTY OF
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS d3 DAY OF , 20'\j
BY )At WHO IS PERSONALLY KNOWN &--' OR HAS
PRODUCED
SIGNATURE OF NOTARY PUBLIC
SLCPDS: 08/06/2014
AS IDENTIFICATION.
PRINT NAME OF NOTARY
(STAMP)
+°•quuup
r�4�+
STET A M. HUNTER
Notary Public - State of Florida
• • -
COt1 MIsslon # FF 180552
My Comm. Expires Jan 23, 2019
Bonded through National
Notary Assn