HomeMy WebLinkAboutSUB CONTRACTOR AGREEMENTA2P0044C RECEIVED NOV 2 ` `15 r '
PERMIT# I I ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
SCANNED
BUILDING PERMIT BY
SUB -CONTRACTOR AGREEMENT I_UCIQ COU11tV
St. Lucie County Contractor Certification Number:
rte of Florida Certification Number (if applicable):
ask ocetan E- CC 4N1'c o
,rnd `(Zy 600ne KOjkq have agreed to be the
(Company Name/Individual Name)
P.�tc) Sub -contractor for C 1n�1
(Type of Trade) (Primary Contractor) '
For the project located at 1401 Swain Rd Fort Pierce FL 34947
(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:
Address:
City/State/Zip:
Phone:
SIGNATURE PRINT NAME DATE
STATE OF FLORIDA, COUNTY OF � C2 ]) c�—
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS L DAY OF N��" �✓ 2yw
BY / wla �" WHO IS PERSONALLY KNOWN ///OR
HAS
PRODUCED `/,� j /��A/SS IDENTIFICATION.
L/%7 CS' ' 7'-�/(STAMP)
SIGNATU OF NOTARY PUBLIC PRINT NAME OF NOTARY PUBLI a.":.+I LINDA PAIOZZOLA
Se°,= Commission N FF 110250
SLCPDS: 08/06/2014 °' " My commission Expires
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