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HomeMy WebLinkAboutSUB CONTRACTOR AGREEMENTPERMIT# l J _© I _ 01Aq ISSUE DATE PLANNING & DEVELOPMENT SERVICES RECE ED Building & Code Compliance Division ���` SCANN BUILDING PERMIT BY PER:v SUB -CONTRACTOR AGREEMENT St.LucieiGouV1tyCounty, FL St. Lucie County Contractor Certification State of Florida Certification Number (If applicable): EC13004033 Tower Communication Services, Inc. have agreed to be the (Company Name/Individual Name) Electrical Sub -contractor for Tower Communications Services, Inc. (Type of Trade) For the project located at (Primary Contractor) 3100 N. AM Fort Pierce, FL 34949 (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: 954-782-8930 A email: towercomsvcs@)bel1south.net 4,-4�V�A�arid W. Clarke SIGNAT RE PRINT NAME 3391 NE 6th Terrace dh [A C. Pompano Beach, FL 33064 STATE OF FLORIDA, COUNTY OF Broward 6/9/16 DATE THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS 9 DAY OF June , 2016 BY Richard W. Clarke WHO IS PERSONALLY KNOWN X OR HAS PR DUCED AS IDENTIFICATION. Tammy Baker (STAMP) / RINT NAME OF NOTARY PUB SiGNA URE O NO RY PUBLIC P """" TA MY C. BAKER Notary Public -State of Florida SLCPDS: 08/06/2014 ��: •`- My Comm. Expires Feb 12, 2017 Commission # EE 847470 Bonded Through National Notary Assn.