HomeMy WebLinkAboutSUB CONTRACTOR AGREEMENTJan. 23. 2015. 4:16PM CENTR.a!, SIGNS
No.5233 P. 1
PERMIT# /5-0/— 0.2", ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division SCANNED
BY
BUILDING PERMIT St. Lucie CounT•
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number: _ r^ v� a O-j /
State of Florida Certification Number (If applicable): I`G�J''I 00 V6-It} _
g�� ;Fled Sl gN�idualTN
C► orye�5 L � 6mK-,RoN have agreed to be the
(Company Nane/ind
Sub-contractor for CQitlCS1 �taNac�$ J nc
(Type of -Trade) (Primary Contractor)
For the project located at 0615 LIS4
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 filing a
Change of Sub -contractor notice. (Form: SLCCDV (No. 004-00)
BUSINESS QUALT: UR (Name of the Individual shown on the Contractor's License)
NOTARIZED SIGNATURES ARE REQUIRED
Business Name; . ( }e =tPli `2i�tJa012 J_tt�
Address: 51 i A ' OLV - 10 1
City/State/ : \ p " A �jCQtd:� 4~ _ 11-I '
Phone,-a5$^ a04Q email: fl+CGtl.q JS tZ Ot CaOi�'�
It • OA--Tmr- J I I ea') 16
SIGNATURE `P/R'INT NAME DATE
y
STATE OF FLORIDA, COUNTY OFOILLSu7i
THEFOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS � DAY OF �J20 1-5
/i
BY l . `{ C5 WHO IS PERSONALL KNOWN OR HAS
PRODUCED
SIGNATURE OF NOTARY PUBLIC
SLCPDS: 08/06/2014
AS IDENTIFICATION.
NAME OF NOTARY
RR
of Florida
RECEIVED JAN V 2015