HomeMy WebLinkAboutSUBCONTRACTOR AGREEMENTSPERMIT # - ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT SCANNED
BY
St Lucie County
ti have agreed to be
(Company Name/Individual Name)
the 01/e e-f r c:1' a 0 Sub -contractor for 126 s' Ct d i 5 e �EKfi «a Cs L
((Type of Trade) (Primary Contractor)
For the project located at 3 S 5' N f �r�K'� Rd, Pe4- ` d -�� , �L 3 q 9 5r3
(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, the Building and Code Regulation Division of St. Lucie County will be
filing of a Change of Sub -contractor notice.
CONTRACTOR SIGNATURE (Qualifier)
)Qlvt ll e., W Qy ✓► e 6 K Vt f C-
PRINT NAME
A9 a 33
COUNTY CERTIFICATIO
State of Florida, County of &JOF _4W1_
e foregoi i instrument was si d before m his y of
y / •F'
r has produced a
vame _ , , ry �FPIYFtf6EEN INN HERRMANN
:• I�U�� ,�? Notary P..ublic'• State o1 Florida
• .� •�, My Comm: Expires Sep 10, 2016
;, �.:, Commission #� FF 129910
Revised 11/16/2016
pursuant to the
COUNTY CERTIFICATION NUMBER
State of Florida, County of�
The foregoing instrument was signed before me this _ - iffiy of
20-6( by
who is personally tmown _"r hlrll duce
as identification. ,, � � <\C�`j�
STAMP '5 /V `' �V — STAMP
Sigialare of Notary Public
Q;Kt�-��Ler_r dk&%Yp&. ANDREADORSEIT
Print Name of Notary Public W COMMISSION # GG 037299
EXPIRES. October 11, 2020
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OmlMThM&dPtNQWy%*"
PERMIT #
ISSUE DATE
PLANNING & DEVELOPMENT SERVICES �° u�'" ��' �g
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT SCANNED
St. Lucie County Contractor Certification Number: 5
Sao
cl� county
State of Florida Certification Number (If applicable): &L 1100 a 3� z
F_C. (LI CA L S 6
have agreed to be the
(Company Name/Individual Name)
EL.�L�1 cAL- Sub -contractor for P_ aQ_AOL5 EITE'Q i0,Q.S LLG
(Type of Trade) (Primary Contractor)
For the project located at 3SS {}.iL dP-aC.tw0 SRO �'D ex- Si . L0LAto r-L_ 3y�
(Project Street Address or Property Tax ID #)
C_
It is understood that, if there is any change of status regarding our participation with the above mentioned
i
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: AL-L LLZ(,TC1 CAA1_ Sis"1 wS -rJC-
Address: poi l t� 1� S i . I_&AZ O i5>'r &,170 �S �-
City/State/Zip: VDRA- Sr 1.. o ,_a ,
Phone: Q(+%% 4 - ou I. o
1 �&
email: iQU. is%Gt�LlUHL51=,QJIc � �� l94nAIL,(Zy1-%
DQ_�LDL.JS1L 07h q /l G
SIGNATURE RINT NAME DATE
r
STATE OF FLORIDA, COUNTY OF `�—
THE REGOING INSTR ENT AS SIGNED BE ORE ME THIS DAY OF , 20-6
BY ,�� WHO IS PERSONALLY KNOWN OR HAS
PRODUCED AA AS ENTIFICATION.
• � � (S AMP)
SIGNATURE O NOTARY PUBLIC P T NAME OF NOTA Y UBLIC
SLCPDS: 08/06/2 14
ANGELA M HUFF
• • �: Notary Public -
' * • State of Florida
-•.
- • 'F Commission # FF
234730
;Fo, «�>a � W Comm. Expires Ma 2019
<' �"n'^ rhrnuglt National Notary
,._ _ al yAssn.