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HomeMy WebLinkAboutSUB CONTRACTOR AGREEMENTt-, PERMIT# O a� ISSUE DATE PLANNING & DEVELOPMENT SERVICES Building & Code Compliance Division SCANNED BY BUILDING PERMIT St. Lucie COIRItb SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: /� (( u l V State of Florida CertificationNumber (if applioable): C�+V L33��188 have agreed to be the For the project located at _ _ `n),0' I 1't( tV' Q I V "V(jl�� j_V (1 (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) NOTARIZED SIGNATURES ARE REQUIRED Business Name: � 1 \ a.t/:`J/��r1as ffiW±i -.a, THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS �""'bAY OF 20JU BY WHO IS PERSONALLY KNOWN OR HAS PRODUCED ��SP C �-L\ AS IDENTIFICATION. H:eN M ,se SIGNATURE NOTARY PUBLIC PRINT NAM OF NOTARY PUBLIC SLCPDS: 08/06/2014 (STAMP) MELODY MEDRICH My COMMISSION # PF238580 EXPIRES June 09.2019 14C7139E-0-53 riwWatba sm#acom PERMIT # 1510-0127 1 1 ISSUE DATE - . PLANNING & DEVELOPMENT SERVICES SC N tL) r Building& Code Compliance Division P St. Lucie Crnmn _._ . BUILDINGPERMIT SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: State of Florida Certification Number (If Wfimbte): EC13001924 t Camouflage Electric, Inc. have agreed to be the (Company Name/fndividual Name) Electric Sub -contractor for Bayview Construction Services (Type of Trade) (Primary Contractor) For the project located at887 E. PrJma Vista Blvd, Pt St Lucie FI ID # A (Project StreerAddress 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) IBUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License) NOTARIZED SIGNATURES ARE REQUIRED Business Name: Address: 460 NW City/state/2ip: Pt St Phone_ 1 /72-340-01 FL 34986 email: .,I . David A. Birth PRINT NAME OF FLORIDA, COUNTY OF St "'Lucie Ste 11 02/01/16 DATE THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS 1 St DAY OF Feb , 2016 BY V FOSi j V�-- w$OISPERSONALLY KNOWN ��ORHAS PRODUCED r J.J La GNATURE OF NOTARY P : C SLCPDS: 08/0612014 VALENTINO PEKr-L My COMMISSION #rF004624 EXPIRES AP613. 2017 (STAMP)