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HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENT ELECTRICAL1d'aI�3 SCANNED 15¢ BY St. Lucie COunN PLANNING & DEVELOPMENT "SERVICES DEPARTMENT "'I 1 "7111 BUILDING & CODE REGULATIONS DIVISION BUILDING PERMIT _ SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: l q 3 ,;? (p State of Florida Certification Number (if applicable): 5-c—.410 d Oq ©hOW 'hive agreed to be the (Company Name/Indi idual Name) sub -contractor for (Type of Trade) (Primary Contractor) for the project located at (,aOak' Dr ( L( 3 Gr-0 V00--6_q ^ 000/0 (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 /. fA�ti' ocrv► ��s�i /U SI PRINT//NAME �^ DATEE mess Name: 14Z4ZA r eel p J "ec 0 (G a L > t/'S��C p. L.r .7 Address: City/State/Zip: � Re Phone: 7 7 - , d -agF a email:. G1 w�ca.S , vt `` nTi 1W1rP1W TPOW nNT .V- PERMIT # L E DATE o�oy • o�q