HomeMy WebLinkAboutSub Contractor Agreement & summary PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
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BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
St.Lucie County Contractor Certification Number:
State of Florida Certification Number(If applicable):
arJL r b Q r c... Q- have agreed to be the
(Company Name xldiuidua ame)
,'ie e Ir mo_ i Sub-contractor for
•(iT_r "_ (Primary Contractor)
For the project located at ,_f(7 Fa-A /,04/4/ )_4/. P_5 15-14 y q
(Project ,tr et dd ss 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:
City/State/Zip:
Phone: email:
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STATE OF FLORIDA,COUNTY OF • 11
THE FOREGOING INSTRUMENTWASSIGNED BEFORE ME THIS •I DAY OF ,20/17
BY 1 + WHO IS PERSONALE OWN OR HAS
PRODUCED Ok• Ac • AS IDENTIFICATION.
+ (STAMP)
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SI ATURE OF OTARY PUBLIC —(/PRINT NAME OF YOTARY PUBLIC
SLCPDS: 12/16/2013
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AUDREYB.HUMPHRFY
MY COMMISSION#FF 1'14772
-XPIRES:March 6,2019
Bonded Thru Notary Pubk tindenwPre
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