HomeMy WebLinkAboutSUB CONTRACTOR AGREEMENTST. LUCIE COUNTY PUBLIC WORKS
h BUILDING & ZONING DEPARTMENT
F<ORIaP.
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number:
State of Florida Certification Number (if appui bte):
Name)
Calrc,! r,1C•x1 sub -contractor for
(Type of Trade)
for the project located at
have agreed to be the
(Primary Contractor)
(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
SIGNATURE
PRINTNAME
Business Name: T
Address:
City/State/Zip:
Phone:
y (, — 6 7
DATE
ST. LUCUCOUNTYPUBLICWORKS
BUILDING ZONINGDEPARTMENT
BUILDINGA'
SUB-CONTRACTORAGIMEMBT
St. Luse County Contractor Certification Number; 19 T Lf q
State of Florida CertifWatiorf Number Of SW ablex CFC0S%958
_S
agreed to be the
tSC
St��Cj eCys D
°Unty
1 YYt�j C � sub -contractor for '` k6 Emis t �(,t&o n
(Type of Twee) (primary Contractor)
for the project located at
(Project Stint Address or Properly Tar Tn 9)
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 QUALF' ER (Name of the Individual shown on the Contmetor's License)
Cr 'AL S \ATV YtE ilEtZLI[—RtE—U
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SIGNATURE PRINT NAME DATE
Dusimess Nanx:
Addraw-
Citymm amp:
PhDue:
OFFICE USE ONLY.
08/11/2006 12:40
7724621735
ST LUCIE CO
PAGE 01
ST_ LUCIE COUNTY XUBLIC WORKS
BUILDING & ZONING DEPARTMENT
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St Lucie Coanty Contractor Certification Number.
State of Florida Certi(cation Number (if appticabk): ac 06 q Z I SQ
' U Sub -contractor for
(Type of`?rade)
agreed to be the
(Primary Contractor)
for the project located at
(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 QUALMER (Name of the Individual shown on the Contractor's License)
01tIGIAI SIGi`IATU�RjE�SAARl RE.
G'i — Y d 6cc lu K S i71 /[ 1 C/4 CV t� r
GNATURE _ rV d
Business Name:
Address:
Citwstate/Zip:
Phone:
PRWf NAME V D
l � 'l � email:
C,q
co/