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BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number:
State of Florida Certification Number (vappiicnbic); ,e�
/Ai 1��. have agreed to be t e
0_CC1__=PVry Name/Individual Name) i
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(Type of Trade)
for the project located at
or
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It is understood that, if there is any change of status regarding our participation
above mentioned project, I will immediately advise the Building and Zoning De
of St. Lucie County by personally filing a Change of Contractor notice. (For-m: S
No. 004-00)
BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's
ORIGINAL SIGNATURES ARE REQUIRED
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Business Name: / /V C-1
Address:
PRINT NAME�
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PLANNING & DEVELOPMENT SERVICES
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St. Lucie county Contractor Certification Number:
State of FI ida Certification Number (If applicable):
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(Type
For the project located at
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Sub -contractor for
have agreed to be the
gtiniary Contractor)
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: SLCCDV (No. 004-00)
BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License)
NOTARIZED SIGNATURES ARE REQUIRED
Business Name.
Address:
City/State/Zip:
Phone:
email:
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SIGNATURE
STATE OF FLORIDA, COUNTY OF
ING INSTRUMENT WAS SIG D BEFORE ME TMS _/�_ DAY OF 20),/
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PLANNING & DEVELOPMENT SERV
_�STLU"CIE Building &-Code Compliance Divisi
COUNTY
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BUILDING PERMIT
RACTOR AGREEMENT
St. Lucie County Contractor Certification Number:
State of Florida Cerfification Number (if appiicabley ��05LI_7 441
bn+�l No als-km S have agreed to be
(Company Naine/Individbal Name)
(Type of Trade) Cl I
a Y\ sub -contractor for
for the project located at
Rem
Street Addre§&)or Prop_e �Tax ID
It is understood that, if there is any change of status regarding our participation
above mentioned project, I will immediately advise the Building and Zoning D
of St. Lucie County by personally filing a Change of Contractor notice. (Form:
No. 004-00)
BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's L
91"AL SIGNATURES ARE REQUIRED
K—INT NAME D6
Business Name: I
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Address: ILY1 P
City/State/Zip:
Phone: Nol— CIO email:
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