HomeMy WebLinkAboutSUB CONTRACTOR AGREEMENTPLANNING & DEVELOPMENT SERVICES
5 ' ' Building & Code Compliance Division
• SCANNED
BUILDING PERMIT BY
SUB -CONTRACTOR AGREEMENT St. Lucie Countv
SL. Lucie County Cantractor Certification Number: -
State of Florida Certification Number (irappacable), Ee. 600 2.-L3 1 —" —
lec(r c—
(Type of Trade)
For the project located at
have agreed to be the
Sub -contractor for �IAIMM' (rrMS%t t ccx�rxt o�-1/ete3 _G
(Primary Contractor)
Street Address or Pro Tmc It #�--.) �[pr � j{tn'E G(ni ✓�-�LIYt VJ
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 QUALM'' IER (Name of the Individual shown on the Contmctaee License)
NOTARIZED SIGNATURES ARE REQ/UIREED ,/YPn
susiness Name: AP_A6o J L/1;/�U/Klt= OL L l-LNC - --
Address: -'9/aO /KTh.: PJA -. i% .. :.;
City/state/Zip: _11L-a1 1Ln..h
Phone: 'l7dn_S 69' 5911 email: aoo/ T
i���%� �. Thomas GaAn»ms
73i,�._
..SIGNATURE PRINT NAME DATE
STATE OF FLORIDA, COUNTY OF t2^Je-i
\ 14
THE FO�RrG_OING INSTRUMENT WAS SIGNED BEFORE ME THIS _Jl DAY OF J 20_
BY 7 tom, S ✓�V Vt _ WHO IS ALLY N x OR HAS
PRODUCED
AS IDENTIFICATION.
SIGNAT" OF NOTARY PUBLIC — ^•"" ". • [T>1Llc,
SLCPDS: 12/16/2013
(STAMP)
,•n+'i CHRIMYSHUUiAN
io ....�e
MY COMMISSION S FF 135252
* * EVIRES: October 21.2018
BOMedtn8ud etNoarySmkes