HomeMy WebLinkAboutSubcontractor Agreement PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
" - BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
St.Lucie County Contractor Certification Number:
State of Florida Certification Number(if applicable):
A f
rvrn r have agreed to be the
(Company Name/In 'vidu rName)
sub-contractor for
(Ty e of Trade) (Primary Contractor)
for•the project located at
o i ee - dress 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: at
City/State/zip: Ft: rM.4 Et ?W92
Phone: 77 2-/7&1-10f email: Coen
C - —/4w"� 0-r-2?
P N HATE
STATE OF FLORIDA,COUNTY OF
TBE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS 2;�)AY OF�� 20/S
BY MBE /-N A47 A WHO IS PERSONALLY KNOWN OR HAS PRODUCEDfh
? ,
A ENTIFICATIO r. (STAMP)
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SIGNATURE N TAR P IC -,�� PRINT N OF NOTARY PUBLIC
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OFFICE USE ONLY: Into
PERMIT# ISSUE DATE