HomeMy WebLinkAboutSubcontractor Agreement PERMIT# ISSUE DATE
y PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
COUNTY
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
St.Lucie County Contractor Certification Number:
State of Florida Certification Number(If applicable):
eFfioM_S - 5CpG1W4-0 et/ have agreed to be the
(Company Name/Individual Name)
r wA _ Sub-contractor for
(T o r ) (Primary Contractor)
For the project located at 650 (34U0 R(f 7'7- ft PRC c r-C. 5W 5,1
(Project Sy -Ad e s or Property Tax ID#)
r
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: ,��77
Address: 10,56, 1 #s1"4ep fag
City/State/Zip: '`T' plQ2C£ f�
Phone: 7� 563 -7k(-5 email:
A NAME
STATE OF FLORIDA,COUNTY OF
THE FO OING INSTRUMENT WAS SIGNED BEFORE ME THIS�DAY OF JXC - ,20 /S---
BY WHO IS PERSONALLY KNOWN OR HAS
PRODUCED141c A, AS IDENTIFICATION.
�' � ✓�QTAMP)
SIGNATURE NOTARY PUBLIC RINT NAME OF NO ARY PUBLIC
SLCPDS: 08/06/2014
'"r`yf'• AUDREY B.HUMPHREY
MY COMMISSION#FF 174772
°i = EXPIRES:March 6,2019
R °4`� Bonded Thru Notary Public Underwriters