HomeMy WebLinkAboutSUBCONTRACTOR AGREEMENTSPLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
BUILDING PERMff
SUB -CONTRACTOR AGREEMENT SCANN
St. Lucieractor Certification Number: / JS i —r �f• LUCie Counfi,
State of Florida Certification Number (If applicable): / l L 3P0 1 Z2 S
' ( UL EL..r C-Cq_t C have agreed to be the
(Company NameAndividual Name) /� II /�
FLecAA \-1 a, ( sub -contractor for Q") Is b V lrj2
(Type of Trade) (Primary ntractor) —
for the project located at Tao 3 S, _;Wall 2 (vet L2
(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)
BtAiness Name:
Address:
City/State/Zip:
Phone:
QUALIFIER (Name of the Individual shown on the Contractor's License)
IIFJZS ARE REQUIRED
�6y_(:; PaLVIC oti11l)V
PRINT NAME DATE
o r l a V-E
S � .� -
�7Z-337- �-/I qI email: bo7Cm Ia aia—a '` -
OFFICE USE ONLY:
PERMIT 0 ISSUE DATE
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
J BUILDING & CODE REGULATIONS DIVISION
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: a tF 3 7 SCANNED
State of Florida Certification Number (ifapplimble): eP & 1 Y S d 33 0 ' BY
1 �U
PO 01 S b V izeK -!:-N(Z.-- have agreed to be the C1ec0UnPl
(Compan)/Name/Indi dual Name)
�sub -contractor for Pno l c 6v G* a y 1NC
(Type of Tr de) (Primaz Contractor
for the project located at '/ o3 S' I0Q, rT 1"ieYcep �L
(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
1N
SIGNA PRINT NAME DATE
Business Name: 001S 6y G 2 e s. TN G
Address: '9" ro S.. Fa d a re / N w y
City/State/Zip: QOCt St. Lucie iL
Phone: 7)d - 33 7— F-213 email: f-ly�P111JSky (�'Re� 4� )Z
OFFICE USE ONLY:
PERMIT # ISSUE DATE