HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENT�✓ `C �f
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it Luck CDcy Cm=cror Cat'diicem Nmg :
//Stet of Florida Cq[ MMUMber (Ir2olid k):
!-1ccup-A-Tr ev-C-MIM ! C jN -rmA
ELEJC-MICA Sub-coA orfm
(Type ofThde)
for the pxgmt located at
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1 04, i , I r z M4
lUdN
SCAlviyuj
WC have agreed to be the
1-12 ahp �1
aft asr con ctot) nsrud
(PigjactStc aAd i orhopertyTax]D # It is naderstood that, if theca is any change of regarding our participation with the
above mentioned project, I will immediately advise the BIpIding and ZoningDepartment
of St. Lucie County by personally fidiag a Cl I e of Contractor notice. (Fay sLca)V
No 004-00) I
BUSINESS QU.ALIFM (Name of the Ind
-01UGENAL S O TURFS ARE MQUMED
A,,
sr T[JRE PRnyrXM
D, Namc ccupA-nr— EL
Address: 730® O7T1
:C�iiy/5tatel�ip: �.7` �7 Z�CIE, ,
171
shown on the Coatraetoes Licwm)
.r r -
DATE
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ST. LUCIE COUNTY PUBLIC WORDS
BUILDING & ZONING DEPARTMENT
St. Lucie County Contractor Certification
State of Florida Certification Number (If a
L) (Company Name/Individual Name) (�
M ln--, G sub -contra
(Type of Trade
for the project located at
NG PERMIT
;TOR AGREEMENT
(�6(a-�
(I,FO- 0 c5l ��a(
for
c . have agreed to be the
(Primary Contractor)
(Project Streei Address or Property Tax ID #)
It is understood that, if there is any chang el 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) I
BUSINESS QUALIFIER (Name of t e Individual shown on the Contractor's License)
O. RIGINA GNATUR ' ARE REQUIRED
mo t; LuA
IG PIR T NAME' DATE
Business Name: Du
Address: L. s I Sw
City/State/Zip:
Phone: 1�r�- `��— Sy3j email: M `;Loc . L�;M
� J
OFFICE USE ONLY:
PERMIT # ISSUE DATE
NNW=PLANNING & DEVELOPMENx' SERVICES DEPARTMENT
a' , BUILDING & CODE REGULATIONS DIVISION
DING PERMT
SUB BiTI-CONTRACTOR AGT49FMENT
St. Lucie Couaty Contractor Cerfi ication Numl
State of Florida Cafficadon Number afamigo
(Campwy Nawe/l 2&Mdual Name)
'�• have agreed to be the
sub -contractor forte
('hype of Thde)
for the project located at
(Project Street Add= or Property T= ID #)
It is understood that, if there is any change
above mentioned project, Z will immediate
of St. Lucie County by personally Ming a
No. 004-00)
BUSINESS QUALIFIER (Name
of status regarding our participation with the
advise the Building and Zoning Department
of Contractor notice. (Form: SLCCDV
Individual shown on the cwt�acWs Lim*
ORIGINAL 'SlGNA S AU REQUIRED
I
i
ST. LUM COM d` I I TBLIC WORKS
DUJLDING & ZONING DEPARIWMNT
I
ORI� $'FJII,b7NG PERN,C��
SUB -CONTRACTOR AGREEMENT
St, Lucie County Contractor• Cortifioa$on Nu bet: °Z rJ1
State of Florida CertWcationNumber (Ifapplimbte):
(Company Name/Individual Name)
lac3Cln - sub-contmctor
(Typr ofTrade)
for the project located at
have agre ld to be the
Acs %dfi0 !h
(Fd=ry Comm for
(Project Street Address or Property Tax JD # )
I
It is understood that, if there is a-ny change of s i #us regarding our pars ,.ipation with the
above mentioned project, I will in=ediatcly advise the Building and � )ning Department
of St. Lucie County by personally filing a Cha Ige of Contractor notice.:. (Fo= SLCCDV
No. 004-00)
ail
]BUSINESS=.RES
me of the Individual shown on the Cont. Ictor's License)
DRIGL TAL SUUREx1 li
$us%ess Name:
Achim:
Cktylstatclzip:
Phone:
RATE
uOn51,®e a �z®®Flag
ONSHORE ROOFING SPECIALISTS, INC.
1501 SE DECKER AVE. SUITE 304
STUART, FL 34994
1OFFICE USE ONLY: -
PERMITS ISSUE IAA
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