HomeMy WebLinkAboutSUB CONTRACTOR AGREEMENTPERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES S
Building & Code Compliance Division CByNEG
St. Lucie
Cnllnt,
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number: L,d cJ ,q
State of Frlorida Certification Number (if applicable): 97— 09 8 ® /5 /
' (Company Name/IndividuarName)
Z�Jl — Sub -contractor for
r
e of Trade) ,
For the project located at
or Property Tax ID
It is understood that, if there is any change of status regarding our
have agreed to be the
(Primary Contractor)
X-r-AA . kdrL 6 r
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 SIGW
Business Name:
Address:
City/State/Zip:
Phone:
emau:
- sA t-t ir,S
SIVNATURE PRINT NAM DATE
STATE OF FLORIDA, COUNTY OF A . e, I
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS I ` DAY OF e P , 20 1 S
BY (1nM p 4�2� WHO I PSONALL O OR HAS
IDENTIFICATION.
(STAMP)
SIGNATURE OF NOTARY
SLCPDS: 08/06/2014 ,p+w Notary Public State of Florida
Tracie L Lamb
My Commission EE 159114
or roof Expires 01/2512016