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HomeMy WebLinkAboutSUB CONTRACTOR AGREEMENTPERMIT # ISSUE DATE PLANNING & DEVELOPMENT SERVICES Building & Code Compliance Division SCANNED BY BUILDING PERMIT St. Lucie County SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: 5- / 22 Q State of Florida Certification Number pfapplicable): 13©J I l oTl��o C �e�J V---P F le cA% L L I_ L— C_ have agreed to be the (Company Name/Individual Name) C_Cz_\ Sub -contractor for C (Type of Trade) rf . (Primary Contractor) For the project located at q `{ i (7 �vyv.M r fG�1 as j L( rG (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. 004-00) BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License) Business Name: Address: City/State/Zip: Phone: SIGNATURES ARE REQUIRED �Z s� Crz-:, A ?7p 3'` e ail: �rllCdcF J �x �L be M1 1_7 S ATURE PRINT NAME DATE STATE OF FLORIDA, COUNTY OF F�1 i �t� �1 V-P_� THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME TBISLV" DAY OF 20 ` I BY _ aV✓I & ( /G,G tRLC WBO IS PERSONALLY KNOWN OR HAS TY/TTT/YTTT /1 J • C 1TT11TTT/1 ♦ TTl WT (STAMP) HE ISSUE DATE PLANNING & DEVELOPMENT SERVICES C I i�a f� Building & Code Compliance Division SCANNED I I - — I BUILDING PERMIT 13Y ENHM" SUB -CONTRACTOR AGREEMENT St. Lucie County St. Lucie County Contractor Certification Number: State of Florida Certification Number (1f applicable): C A C 19 15 � S9 Y_u i-,p Y, uory)i I -lti o n 1 on have agreed to be the (Company Name/Individual Name) Wl I N�-v i IMSub-contractor for 0,on7h'/ick geyuiGe, (Type of Trade) JJ (Primary 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 QUALIFIER (Name of the Individual shown on the Contractor's License) NOTARIZED SIGNATURES ARE REQUIRED Business Name: Address: City/State/Zip: Phone: email: S2VV ICE SA-agA I i u Q 1 . Corn SIGNATURE PRINT NAME DATE p STATE OF FLORIDA, COUNTY OF _ 1 n d1 C, ,r1 ,Q ; f1J rr THE ��FgqOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS/ 5 DAY OF S eM 6& 20 )-S VV BY �_tA_)pOU / WHO IS PERSONALLY KNOWN OR HAS PRODUCED 7L Dri Jo S l-1a4ige AS IDENTIrrFICATION. " %etc' (STAMP) NO IGNA URE OF NOTARY PUBLIC PRINTF NOTARY PUBLIC SLCPDS: 08/06/2014 oLEAGHLA D. HIRSCHFELD 2• ♦Ci Notary Public . State of Florida My Comm. Expires Jan 27. 2017 Commission # EE 6fi6607