HomeMy WebLinkAboutSUB CONTRACTOR SUMMARY-AGREEMENTPERMIT #
ISSUE DATE '
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
S(;HNNtI-
BY
St. LUCie rnI Int
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number
State of Florida Certification Number (Irapplicabte): f6 /.3,!:V Z 7 Y/
a 7Aze, J �in c' have agreed to be the
pmpa Name/IndividualName)
'; Gta 1 Sub-contractorfor 'awx) lkchJS
(Type of Trade) (Primary Contractor)
For the project located at l 1225 S, US
(Proiect Street Address
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 Cou ractoes License)
Business Name:
Address.
City/State/Zip:
Phone:
-27z- 2/6-Oy-'/g
r
> > Cary,
SIGNATURE PRINT NAME DATE
STATE OF FLORIDA, COUNTY OF S�— 1 T r). L
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS 2 DAY OF �2 w.�an-i , 20 % S
By Nk 0I k\ �exP l�wt wkQ,r4.� WHO LS ERSONALLY HIVOWN OR HAS
P UCED C A' "'A'
\t`15x� �P it �0. �+_ (STAW)
S GNATURE OF NOTARY PUBLIC PRINT NAME OF NOTARY PUBLIC
SLCPDS: 08/06/2014
.• � SUSIETEfREAULT
WCOMMISSION9FF9t7052E
a� EXPIRES: September 13, �19
`EON eaweammramryaunscu+�rs
PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES ` GAIVIVtt
Building & Code Compliance Division Sf. CUCB
so- e
- -_ _--- BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number. I
State of Florida Certification Number (If applicable): C FC V13 ,yio a,
have agreed to be the
(Cori 1Name/Individual Name)
lt�tN� Sub -contractor for J oY� in J Q Co �o S �o n S KU Pal I r�/
(Type of Trade) (Primary Contractor)
For the project located at
Street Address or Property Tax 1D #)
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: SLCCDY (No. 004-00)
BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License)
NOTARIZED SIGNATURES ARE REQUIRED
Business Name:
Address:
.OkV\
city/State/Zip: Fa- P\ercA— , Vc,, 3'1a 8 ,
THE FOREGOING
C(oI• ()D`V
111,23)1 f
DATE
COUNTY OF T a i a .I
31415i
WAS SIGNED BEFORE ME THIS 2--> DAY OF N bV W,6a--� 20J-S:
BY ��P A�A� Dy► r y R T2 O@���`��i WHO IS PERSONALLY KNOWN ✓ ORHAS
P DUCED
SIGNATURE OF NOTARY PUBLIC
SLCPDS: 08/06/2014
AS IDENTIFICATION.
PRINT NAME OF NOTARY PUBLIC
:F �97i'c SUSETMW&T
•: .: MYCOMUSSM OFF BOOM
`• EXPIRES: September 13.2019
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(STAMP)