HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENTy
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PERMIT # - -• ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
SC .By
St. Lucie County
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number:
State of Florida Certification Number (Ifapplimble):
' For the project located
(Primary Contractor)
to be the
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)
NOTARIZED
Business Name:
Address:
City/State/Zip:
Phone:
QUALIFIER (Name of the Individual shown on the Contractor's License)
ARE REQUIRED
— it/IIPAf _ email:
ZTATE
TURE P NAME DATIE
OF FLORIDA, COUNTY OF I I ,�, jj 1 n
THE FOREGOING iNNST_RU 1M/'ENNTT W,,AS�jSIIGN�� BEFORE ME THI� DAY O r I L9 20 I "-
BY ��1 1'( \{ , u' _�eab WHO IS PERSONALLY KNOWN OR HAS
PRODUCED
IDENTIFICATION.
L •:� - cM I.e L.haag&
SIGNATURE OF NOTARY P B IC PRINT NAME OF NOTARY POLIC
SLCPDS: 08/06/2014
•—"neLLE LEE DAGGET,
MY COMMISSION #FF7B5075
SPIRES Oecsmbe.22 2018
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