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
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SIGNATURE PRINTNAME qDTIE
Business Name:
Address:
City/State/Zip:
Phone: email:
PERMIT # sISSUE DATE
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PLANNING & DEVELOPMENT SERVICES
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! Building & Code Compliance Division
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BUILDING PERMIT
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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
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