HomeMy WebLinkAboutSUB CONTRACTOR AGREEMENT�_ PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
• ■ SCAN NEp
BUILDING PERMIT BY
SUB -CONTRACTOR AGREEMENT -91 Lu* County
St. Lucie County Contractor Certification Number.
State of Florida Certification Number (if appiimbie):
Case
Name/Individual
have agreed to be the
`i�LUMQ(A/Cz Sub-contractorfor CAA1z0i,(L Ct7�L(n1S
(Type of Trade) (Primary Contractor)
For the project located at
Street Address or Property Tax ID it)
333 OOoi -
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 QUALIFIER (Name of the Individual shown on the Contractor's License)
NOTARIZED SIGNATURES ARE REQUIRED
Business Name: L-WDQui sr 'P)LUM(3(I &
Address: 3231 0LEf-J1J0E2 A-(W,
City/State/Zip: Fo2-r Pig R-cr✓l 6—
Phone: 7 7 Z. N (of - 9 (o el email:
SIGNATURE PRINT NAME DATE
STATE OF FLORIDA, COUNTY OF _ Sr. UJ UE
THE FOREGOING INSTRUMENT( /- WAS SIGNED BEFORE ME THIS DAY OF J1h1 Q/}R V / 201(,
BY A o �12/y Cf �( � WHO IS PERSONALLY KNOWN ! , OR HAS
PRODUCED
Y 't
RE OF NOTAGPUBLIC
SLCPDS: 08/06/2014
AS IDENTIFICATION.
PRINT NAME OF NOTARY PUBLIC
LJsa M. Johns Grose
G9d'f10I'PpUBL10 54
STATE OF FLOPJDA
Comm* FF208991
Expires 3/11/2019
PERMIT# ISSUE DATE
_ ____ _ _ PLANNING & DEVELOPMENT SERVICES
- wtah Building & Code Compliance Division
Mill ,
BUILDING PERMIT SCAN N L- C
SUB -CONTRACTOR AGREEMENT �11C�B Cn`1nt
St. Lucie County Contractor Certification Number. 2 o Q S
State of Florida Certification Number (ifappiiabicy Eta 00001 ZZ
LAt%j e
(Company
Name)
agreed to be the
rI'Ej=%C, Sub -contractor for 0-fi i-oa- (,C7trt,rPjS
(Type of Trade) (Primary Contractor)
For the project located at
Street Address or Prodertv 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. oo4-oo)
QUALIFIER (Name ofthe Individual shown on the Comrector's License)
NOTARIZED SIGNATURES ARE REQUIRED
Business Name: L" E LzCTT(t-tC
Address: Q 0• &U 12 (o 7to
City/State/Zip:
Phone:
C77Z) -570 � 421(o email:
'SIGNATURE
tP
PRINT NAME DATE
STATE OF FLORIDA, COUNTY OF ST . W C(-C-
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS 1 DAY OF J FlyL1tJ&I 120 P(_-
BY jS I A w WHO IS PERSONALLY KNOWN '4""' OR HAS
PRODUCED
IDENTIFICATION.
% �LSQ K, Jo 1fS- 6�t ¢SSG
SIGNATURE OF NOTARY PUBLIC PRINT NAME OF NOTARY PUBLIC
SLCPDS: 08/0612014
(s�crone
r,or Pueuc
STATE OFF A
' � 3(t1la019