HomeMy WebLinkAboutSubcontractor Agreement PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
s r
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
St.Lucie County Contractor Certification Number:
State(( Ann
offFlorida Certification Number(if applicable):
t'' b' Ise = have agreed to be the
ii (Company Name/Individual Name)
eli�r1�G Sub-contractor for
(Type of Trade) (Primary Contractor)
For the project located at 0 I, � ('-�' 016
(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:
Address:
City/State/Zip:
Phone: email:
GNATURE MINT NAZE t DA—T1
STATE OF FLORIDA,COUNTY OF
THE FOREGOING INSTRUM T WAS SIGNED BEFORE ME THIS I" DAY OF ,201_GBY, � WHO IS PERSONALLY KNOWN
OR HAS
P DUCED AS IDENTIFICATION.
(STAMP)
SIGNATURE O NOTARY PUBLIC P INT N I€A M HUFF
� ,+„°p+:`'�M °n►rnlsslo State Of
F110 08/06/2014 Y Corti rt+lE FF Florida
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