HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENT-PLANNING & DEVELOPMENT SERVICES DEPARTMENT,
BUILDING & CODE REGULATIONS DIVISION
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number:
State of Florida Certification -Number (if pplicabi6)::'71_"A c--)a. `' at_5 3
have agreed to be the
(Company. Name/Individual Name);
sub -contractor for J `S n�1L� `�-,� W D- -
(Type. of Trade) (Primary GoGtor)�
.Wz_, aN
for the project located at»�a� �•OC e�c�`��� �eN, ;
(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
JJ'RuiS5�v4r" 1
SIGNATURE0 PRINT NAME
DATE
Business -Name:
Address: V�q N�,
City/State/zip::
Phone: ' ��?J ���' c7 �� ' email:
OFFICE USE ONLY: .
PERMIT # ISSUE. DATE
PLANNING & DEVELOPMENT SERVICES DIVISION
'BUILDING & CODE REGULATIONS DIVISION
2300 Virginia'Ave.
Fort PiercejL 34982
BUILDING PERMIT
SUB -CONTRACTOR SUMMARY
will be using. the following sub -contractors for the -
(Company/Individual Name) .
project locate_ d at �0��
S CPC\ \. >� 33
(Street address or Property Tax ID_#)
. It is understood that if there is
any change of status regarding. the. participation of any of the•sub-contractors-
listed below; I will immediatelyadvise.the.Building and Zoning Department of St. Lucie County. .
St: Lucie County/.. :.
Trade .
-Name .of Company/Contractor.
State of Florida
License Number
Electrical
Plumbing ..
S �b��e
\C�'� �'3
Mechanical
Roofing
-
Gas
OFFICE USE ONLY
PERMIT -
NUMBER:
ISSUE DATE: