HomeMy WebLinkAboutSubcontractor Agreement PERMIT# ISSUE DATE
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F PLANNING & DEVELOPMENT SERVICES
' - Building & Code Compliance Division
BUILDING PERMIT
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SUB-CONTRACTOR AGREEMENT
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St.Lucie County Contractor Certification Number:
State of Florida Certification Number(If applicable): (�C 1 3 3 9 '
P Y it
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1-2-c>oG� I have agreed to be the
(Compare Name/Individual Name) �� I'I
,2,00 N Sub-contractor for 1,1C ki i �2
(Type of Trade) I (Primary Contractor)
For the project located at 3� u t,U �1 eeN j��' 2�, c e�2C
(Project Street Address or Propex0ax 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
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Business Name: S< l 1 2e>d — ( t j
Address: t�o / 6
City/State/Zip: 3
Phone: ��o� �VZ ��.'� email: 1456 1(.5 000T(tel
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SI PRINT NAME DAT
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STATE OF FLORIDA,COUNTY OF eA U U, l ,
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THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME TS 3 DAY OF �A._cC Vk ,20t
BY Au P1'' �V�� WHO IS PERSONALLY KNOWN OR HAS
PRODUCED AS IDENTIFICATION.
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(STAMP)
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SIGNATURE OF NOTARY PUBLIC AUNT NAME OF N OT6RfPUBLIC
SLCPDS:08/06/2014 ;spat Nie,,, MA DE A Luz VELASCO
Notary Public-State of Florida
•2 My Comm Expires Nov 1,2016
Commission#EE 846616
Bonded Through National Notary Assn.