HomeMy WebLinkAboutSUBCONTRACTOR AGREEMENTPERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES SCANNED
BY
Building & Code Compliance Division St Lucie Countv
sus-CONTRACTORAGREEMENT RMIT RECEIL'ED JUC.2 72015
St. Lucie County Contractor Certification Number: 1! S4
of Florida Certification Number (ff applicable): e % u i o le�
ffl a4z?" r—b have agreed to be the
°z (Co y Name/Ind' idual Name)
Sub -contractor for i t
(Type of Trade) (Primary Contractor)
For the project located at
,S,#—
(Project Street Address or Property Tax 1D #)
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 RE UIRED
Business Name:
Address:
City/State/Zip:
Phone:
i
WE WAN�0'
SIGNATURE PRINT M
DM ISTATE OF FLORIDA, COUNTY OF _ n
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIqq2�DAY OF A
�20
BY p Aye �n07 � WHO IS PERSONAL Y KNOWN k _— OR HAS
SIGNATURE OF NOTARY PUBLIC
SLCPDS: 08/06/2014
IDENTIFICATION.
$OON Notary Public State of Florida
_��8(/' Tracie L Lamb
My Commission EE 159114
%M Ezplres 01/25/2016
(STAMP)