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HomeMy WebLinkAboutSUBCONTRACTOR AGREEMENTSPERMIT# i I ISSUE DATE PLANNING &.DEVELOPMENT SERVICES Building & Code Compliance Division BUILDING PERMIT SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: State of Florida Certification Number (if applicable): Sub -contractor for (Type of Trade) For the project located at SCANNED BY St. Lucie County have agreed to be the 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 w\"� b, , ' y jl v Business Name: Address: City/State/Zip: Phone: email: SIGNATURE -PRINT NAM a DATE STATE OF FLORIDA, COUNTY OF ♦ 11-f THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS3 I DAY OF 20 /y BY �� L WHO IS PERSONALLY KNOWN OR HAS PRODUCED ' "UA�iI 1, {T(1t AS IDENTIFICATION. (STAMP) SIGNATURE OF NOT Y PUBLI PRINT NAME OF NOTARY PUB IC„. ,,, DAWN MiLONE aMjt pv°'•, Notary ;° y Public -Slate of F '2 SLCPDS: 12/16l2013 ;. ° ; My Comm. Expires Mar 22 2017 Commission # EE 877571 ''.'„�e°� ��o•�' Bonded Through National Notary Assn. -(1 PERMIT # ISSUE DATE PLANNING & DEVELOPMENT SERVICES Building & Code Compliance Division BUILDING PERMIT SUB -CONTRACTOR AGREEMENT SCANNED St. Lucie County Contractor Certification Number: �'I, L�l6g �OFIYl1y State of Florida Certification Number (If applicable): For the project located at Sub -contractor for Street Address or Property Tax ID (Primary Contractor) have agreed to be the J 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 RE, QUH2ED Business Name: Address: City/State/Zip: Phone: email: [� SIGNATU / PRINT NDATE STATE OF FLORIDA, COUNTY OF., =,,(� b„Q THE FOREGOING,INSTRUME�T WAS SIGNED BEFORE ME THIS 31 DAY OF 20 BY PRODUCED �L �— SIGNATURE OF NOT Y PUBLIC PRINT SLCPDS: 12/16/2013 7d-eaY3— O�-t WHO IS PERSONALLY KNOWN OR HAS AS IDENTIFICATION. (STAMP) 'M "�•� DAWN MILONE Notary Public -State of Florida My Comm. Expires Mar 22, 2017 Commission # EE 877571 Bonded Through National Notary Assn. PERMITA! ISSUE DATE PLANNING & DEVELOPMENT SERVICES Building & Code Compliance Division BUILDING PERMIT SUB -CONTRACTOR AGREEMENT SCANNED St. Lucie County Contractor Certification Number: BY St County State of Florida Certification Number (if applicable): Lucie For the project located at Sub -contractor for (Primary Contractor) Street Address or Properly Tax ID #) have agreed to be the 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 C�rw Y W Business Name: Address: City/State/Zip: Phone: email: SIGNATURE PRINT NAXt DATE STATE OF FLORIDA, COUNTY OF 22 THE FOREC�ING INSTRUMENT WAS SIGNED BEFORE ME THISV I DAY OF 20 BY WHO IS PERSONALLY KNOWN OR HAS PRODUCED AS IDENTU+ICATION. ..Il " , A DAWN MILONE SIGNATURE OF NOT Y PUBLIC PRINT NAME OF NOTARY PUBLI io`� / •, Notary Public - State of Florida • _ My Comm. Expires Mar 22, 2017 ' ^' k: c3 SLCPDS: 12/16/2013 P. Commission # EE 877571 ��', R.. PP'�- Bonded Through National Notary Assn.