HomeMy WebLinkAboutSUBCONTRACTOR AGREEMENTPERMIT # ISSUE DATE
1'
" PLANNING & DEVELOPMENT SERVICES
5 �' I` Building & Code Compliance Divisioli
o RECEIVED
° c ° BUILDING PERMIT DEC 18 2018
" SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number: ! ! ST. LuEle 12080 ,. MM
State of Florida Certification Number (If applicable):
have agreed to be the
(Company Name/Individual Name) SCANNED
= �f i-VC_zq�_L Sub -contractor for BY
(Type of Trade) (Primary Contractor) St. Lucie County
For the project located at
Address or Property Tax ID ti)
It is understood that, if there is any change of status regarding our participation with the above mentioned
project, 1 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)
BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License)
NOTARIZE' D SIGNATURES �A1RE RrOUIRED
Business Name: 22� �Iub�l+
Address: 5 O 1 J ,L R W S R A UL
City/State/'Lip: .
Phone: 10
STATE OF FLORIDA, COUNTY OF
email:
ROQ,gai a
PRINT NAME DATE
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS [A DAY OF I'DP C , 20 t 8r
BY 80 6 Pck k k WHO IS ERSONALLY KNOWN i OR HAS
PRODUCED AS IDENTIFICATION.
(STAMP)
SIGN URE OF NOTARY PUBLIC
SLCPDS: 08/06/2014