HomeMy WebLinkAboutSubcontractor Agreement PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
• M
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
St.Lucie County Contractor Certification Number:
StateCertification Number(If applicable):
of ida
r_*+J1 /� have agreed to be the
(Com any Name/In, u ua awe
Sub-contractor for
(Primary Contractor)
For the project located at �n �� � —�-- PJQld-0.2 F1 (n
(Prof M Street Afdr s 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: n
Address: y
City/State/Zip: —+- P 1,eir`C p
Phone: 7?� Z��e���Z email:
l 7f De
IGNATi r IE T
STATE OF FLORIDA,COUNTY OF
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS__�4 DAY OF ,20 /S
BY tk�102ej- WHO IS PERSONALLY KNOWN OR HAS
Z
PRODUCED _ JA.4AS IDENTIFICATION.
fiq�,,4. i , 6 �4�
�.{��� L�� (STAMP)
SIGNATURE OF TARY PUBLIC RINT NAME OF OTARY PUBLIC
SLCPDS: 08/06/2014
MOREY&.HUMPHPEY
+ MY COMPdISSiiJIJ#FF 174772
�•�,o EXPIRES:March 6,2019
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