HomeMy WebLinkAboutSUB CONTRACTOR AGREEMENT02/12/2016 13:58 FAX1 -',NEI'-D FES 12 2016 R0004/0004
PERMIT # �& Qa _ Q 4UO ISSUE DATE
Sjr 3jz PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT SCANNED
SUB -CONTRACTOR AGREEMENT BY
St. Lucie County Contractor Certification Number: 'd � /�`6 d y St. Lucie County
State of Florida Certification Number (If applicable): �/
r-elzaa6A5/DOA) SCHNEIDC1z have agreed to be the
(Company Name/Individual Name)
'Le GAS Sub-wntractor for M119E /YI6FAat.4YJD
(Type of Trade) (Primary Contractor)
For the project located at /0537 ,C> CCC-141,j RLU p , JCA-5uj /5CAUi, rG 31/0S -2
(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: rerrellQAS >,gpn) 9eHNelbe2.
Address: 3 a 3 2 S (^ I) i 3e,(F 14 w K
City/State/Zip: S1' u ykrL--C T-- t-.__ 31
Phone: D 5(ol-WO(g 0S email: Dean ScNN�iDEf2�GCrro//�ys •�O�
DE)IrJ SCWA161bE2
SIGNATURE PRINT NAME DATE
STATE OF FLORIDA, COUNTY OF "cTIO
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS 97-H DAY OF i;56f1.0It(C,4 , 20 Ka
BY DEAAI SGI/!JE/(K WHO IS PERSONALLY KNOWN OR HAS
PRODUCED
AS IDENTIFICATION.
SIGNATURE OF NOTARY PUBLIC PRINT NAME OF NOTARY PUBLIC
SLCPDS: 08/06/2014
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