HomeMy WebLinkAboutSUBCONTRACTOR AGREEMENTI
PERMIT# I Xul 7 00, 0,341 ISSUE DATE 1 7
NING & DEVELOPMENT SERVICES
Building & Code Compliance Division
SCANNED
BY
St. Lucie County
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number: 2 3 -3 F 0
State of Florida Certification Number (If applicable): GPI F50149-S-0
S 1r::7A 140 S5 EL&Z-Ta I C I N C_ -
(Company Name/Individual Name)
J2 B_--ryz I C+L— Sub -contractor for
(Type of Trade)
For the project located at
� I
�J,L -3�05- OCO/
(Project Street Address or Property Tax ID #)
have weed to be the — ,
,S?AC
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 AM REQUIRED
BusinessName: !E;;,C:7A W os5; t_--LL-7_M
Address: k-�02 Se
City/State/Zip:
P -7-7Z-Zol- SqVI email:
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ATURE PRINT NAME DATE
STATE OF FLORIDA, COUNTY OF MV24 i �J
h 44,
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS [FDAYOF
BY
PRODUCED
L-JuW400d
SIGNATURE OF NOTARY PUBLIC
SLCPDS: 08/06/2014
AS
ISPERSONALLY
I. M127—
is'
,20-6-
OR HAS
(STAW)
CAF11 S. CHAU55
7 1— , .
Notary'Public - Stalaol Florida,
My Comm. Expi�es Dec 3, 2016
1"3�F commission # EE 223545
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