HomeMy WebLinkAboutSUB CONTRACTOR AGREEMENTPERMIT #
1509-0514
ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division RIECEIVE
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number:
State of Florida Certification Number (If applicable): r c cc�oo / D �-
(Company Name/Individual Name)
6:IP<*-, G Sub -contractor for
(Type of Trade)
SCANNEL OCT 0:8 2015
BY
St. Lucie Colmt, PERMITTING
St. Lucie County, FL
(Primary Contractor)
have agreed to be the
For the project located at 375 E Midway Road Ft. Pierce, FL 34982
(Project 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. oo4-00)
.. p
_BUSINESS QUALWMR (Blame of the Individual shown on the Contractor's License}
NOTARIZED SIGNATURES ARE REQUIRED
Business Name:
Address:
caylsunciz* t,
Phone:
_ 'SIGNATURE _ PRINTNAM/E DATE
STATE OF FLORIDA, COUNTY OFarOf
THE FOREGOING ]INSTRUMENT ERSONALL' WAS SIGNED BEFORE ME THIS � DAY OF � � �' j �20
BY 11jkalVe WHO POWN '� OR HAS
PRODUC AS IDENTIFICATION.
(STAMP)
°, ,,, LINDA PALOZZOLA
SIGNATURE OF NOTARY PUBLIC PRINT NAME OF NOTARY PUBLIC .� Commission # FF i 10250
SLCPDS: 08/06/2014 'o 0 1e"o+ MY A°P if 07. 2 Expires
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