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HomeMy WebLinkAboutSUB CONTRACTOR AGREEMENTSPLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION BUILDING PERMIT SUB -CONTRACTOR AGREEMENT St, Lucie County Contractor Certification Number: State of Florida CertificationN(u�mber (ifappiicame): Ti I O aS- 4 USAS q0 Y1A_V,e VkTW'thave agreed to be the (Company Name/IndividualName) ( ( Q t V� sub -contractor for (Type of Trade) ('Primary Contractor) for the project located at 33 LE) ' QC Ak� (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 L;f�ps nc�,t.( y 13 SIGNATURE PRINTNAME qDTIE Business Name: Address: City/State/Zip: Phone: email: PERMIT # sISSUE DATE 1`10 PLANNING & DEVELOPMENT SERVICES .� ! Building & Code Compliance Division 5 r BUILDING PERMIT a SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: State of Florida Certification Number (Ifapplicabie): (,? /E0 6,T /Y : / /Y r C �c r2/ c �6. i/YC, have agreed to be the (Company Name/Individual Name) ,Cs�cT.e. Crae. Sub -contractor for (Type of Trade) (Primary Contractor) For the project located at j�j � g �Y G�11�1�Q e # -�15 ` -n ' P1 �eyCe -,2n 3u Cl V� (Project Street Address or Pr4oerty 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 filing a Change of Sub -contractor notice. (Form: SLCCDY (No. 004-00) BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License) NOTARIZED SIGNATURES ARE REQUIRED Business Name: Address: le SQ Nag /i/V/rS F•� City/State/Zip:. ,/1iM✓CrrH/ez %L 33'Y�S Phone: .S(o/-(vba'?-2.-299 email:j,�El.[SOv.�•v./VB'T S!i%IEy � � /E�0. 2oiy I A I T NAME A DATE J STATE OF FLORIDA, COUNTY OF v� 41 ✓ 1 9 THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS 4 DAY OF �( I 20 1 I BY �r o. UM`C" I QWHO IS PERSONALLY KNOWN OR HAS PRODUCED ) /�A! J� `' 1- 74) 1 3`05-7� AS IDENTIFICATION. I"%��/'�/j\ / � (STAMP) S GNATURE OF NOTTAARrY—P—UBBLLI'C PRINT NAME OF NOTARY PUBLIC SLCPDS: 12/16/2013 DLANa is NotarStata of FloridaMy Coes Mar 25, 2016o„com# EE 162599