HomeMy WebLinkAboutSUB CONTRACTOR AGREEMENTPLANNING & DEVELOPMENT SERVICES DIVISION
N BUILDING & CODE REGULATIONS DIVISION
2300 Virginia Ave
(Company/individual Name) - -
P�lec ocatedat Mfg N Knp AyV.-
(Street address r Property Tai'ID 11)
It is understood that if there is any change of status regarding the participation of any of the sub -contractors
listed below, I will immediately advise the Building and Zouipg Department of. St Lucie County.
Trade
-_
Name of Company/Contractor
.. St. LueieCoataty/
State of Florida
License Number
Electrical
I / .
AI I PhRS�Rec kcOAt, c%o!� .G,
FG cib6a%
Plumbing
HVAC
Mechauical
Roofing
_-Gas. _:..
. ............ ._ _. ..... . _. _'........
_ ..
Q MCF.USE ONLY..
PERMIT i ISSUE DATE:
NUMBER: i Ov34
PLC•"TNING & DEVELOPMENT S.""VICES
3uildingA Code Compliance L=_]sion
BUILDING PERMIT SCANNI=u
SUB -CONTRACTOR AGREEMENT BY
St. Lucie r-
St. Lucie County Contractor Certification Number: IM 5
State of Florida Certification Number (If applicable): - E c,
(Company Name/Individual
have agreed to be the
Fled'( i C, sub -contractor for
(Type of Trade) (Printery Contractor)
for the project located at
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 4)UALD71ER (Name ofthe Individual shown on the Contractor's License)
NOTARIZED SIGNATURES ARE REQUIRED
BosinessName: 41/ Ad re 4 C*;C- [ �n7 ,/ ,/'t 'T,
Address: 7 // Gpd n" sif-
City/State/Zip: Foci' P/ e rcce F/ ?
RIN
4i;7;
O- email:
AW D
STATE OF FLORIDA, COUNTY OF Uk.
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS /6 DAY O 20 /�
BY WHO IS PERSONALLY KNWN _KOR HAS PRODUCED QR kQ Q
ID NTIFI I
S GANATURE OF O Y PUBLIC i:,Ji
OFFICE
OF NOT Y e�.,, LUCIA MEDIA
III
¢NoyrY Public - State of Florida
xMYComm. Expires Oct 11, 2016
K. Commission 8 EE 842817