HomeMy WebLinkAboutSUBCONTARACTOR AGREEMENTSST. LUCIE COUNTY PUBLIC WORKS
BUILDING & ZONING DEPARTMENT SCANNED
BUILDING PERMIT BY
SUB -CONTRACTOR AGREEMENT St. Lucie COUCIY
St. Lucie County Contractor Certification Number: 2-1 `SS
State of Florida Certification Number (Inapplicable): 'F y__1 12) 0 l '�)070
61erGlzea �r:'"i'V i'CQS I`ne have agreed to be the
((dmpany Name/Individual Name)
sub-contractor for
(Type of Trade) (Primary Co tractor)
for the project located at /' aSOA(aq
(Project Street Address or Property T x 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 SI ATURES ARE REQUIRED
.� N1 -C1ae1 FICA rna.n o
SIONA PRINT NAME DAT
Business Name:
Address:
City/State/Zip:
Phone:
.. fit♦; ��
0 •
OFFICE USE ONLY:
PERMIT# ISSUE DATE
6 r. LUCIE COUNTY PUBLIC WORKS
BUILDING & ZONING I 'ARTMENT
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number.
State of Florida Certification Number (If applicable):
SCAB[ � ED
/ 9-33 St. Lucie County
9200353170
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
Form (SLCCDV FORM NO. 004-00).
Knatre
QUALIFIER (original signatures required):
Vhnt //me Date
business name: DoLS' ze 6et
address: jfsL S as .
city,state,zip: 0.2r SY C,'e C- 3 S_?
phone: 77.Z 3Sti—f7 3
SLCCDV FORM NO.: 002-00
ISSUE DATE