HomeMy WebLinkAboutSUB CONTRACTOR AGREEMENTPERMIT # fi � 0 q
0 `1 9fl 1 ISSUE DATE
PLANNING & DEVELOPMENT
t ' °" ` -t Building & Code Compliance Division
SCANNED
BUILDING PERMIT BY APR 2 9 2016
SUB-CONTRACTORAGREEMENT St. Lucie Couf
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St. Lucie County Contractor Certification Number: St. Lucie Count FL
State of Florida Certification Number (if applicable): C: — / H C z
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have agreed to be the L
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(Company Name/Individual Name) /� /
61= -f-� .1 ie- ( Sub -contractor for 0o/ttcQ�i A%GXK, hZ, ( i�-.�
(Type of Trade) (Primary Contractor)fo
For the project located at
(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: tJ C z w
Address: l C 7 <� S. A/ C /y1 r V laic• t o iZe /to
City/State/Zip: t/dAat J6v /LlGtC . 6r�_L S7l S—
Phone: email: c tiJGZyy f' yQUl• ��
SIGNATURE PRR NA E DATE
STATE OF FLORIDA, COUNTY OF SR1�L tC
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS DAY OF 1 L 20&Y
BY )C1 UA;nC-Z�4 1A WHO IS PERSONALLY KNOWN OR HAS
PRODUCED
.6a/kid �e-
SIGNATURE OF NOTARY PUBLIC
SLCPDS: 08/06/2014
IDENTIFICATION.
(STAMP)
Mwl
DIANE COLE
.�, Notary PublicSbU of FlorMa
Commission # FF 971317
'1.A.�;;Q� Bonded IWOU0NallooMWay Ass,
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