HomeMy WebLinkAboutSubcontractor Agreement i
PERMIT# ISSUE DATE
i
w� PLANNING & DEVELOPMENT SERVICES
' 5 Building & Code Compliance Division
Inns= i
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
St.Lucie County Contractor Certification Number:
State of Florida Certification Number(If applicable):
have agreed to be the
(CompanyNamet.n iv
'duLLame)
Sub-contractor for
(Type` of Trade) (Primary Con actor)
For the project located at l s �_ rL 5I-6F5 t F _�? q (�&-
(PZoject eet 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)
NOTARII ED SIGNATURES ARE REQUIRED
Business Name:
Address: /,2/ 6 iotl 1
City/State/Zip: �S 17t 3
Phone: email:
/o 1, 1 D dA il C,- 5 _
A l' RE�* IfLYIN°t1•IVIE DA
STATE OI FLORIDA,COUNTY OF
THE FORIEGOIN INSTRUMENT WAS SIGNED BEFORE ME THIS!?DAY OF / / ,20/ (P.
0 h lt��
BY I M WHO IS PERSONAL OWN OR HAS
PRODUG D AS IDENTIFICATION.
SIGNATURE O OTARY PUBLIC P T NAME OF NOTARY P BLIC �•
SLCPDS:I 08/06/2014
�;�;Pyr- AMF EY B.FNMPHREY
J MY COMMISSION FF 2019?
EXPIRES:March 6,
Bonded 7hru Notary Publnderwrits
ic Ues
F1
PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
St.Lucie County Contractor Certification Number:
State of Flo i ida art' �ionumber(If applicable):
5),;,1A __LJ_ have agreed to be the
(Company Name v ual="N`Tme
b 1 h 4 Sub-contractor for
pe of Trade) (Primary Contractor)
For the project located at / _ pp
(Project Qp. ddress 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)
NOTARII ED SIGNATURES ARE REQUIRED
Business Name:
Address:
City/State/Zip: S L- 3
Phone: ! < / email:
SG)\�AT RER' a A`M ISA �E
V
STATE OIF FLORIDA,COUNTY OF
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS_ DAY OF ,201k
By 1 I m WHO IS PERSONALE - OWN OR HAS
PRODUCED AS IDENTIFICATION.
J • VI, b 12 L° I�-rvl. TP r
om
SIGNATURE OF TARP PUBLIC P T NAME OF NOTARY PU LIC
SLCPDS 108/06/2014
AUDREY B.HUMPHREY
'a' MY COMMISSION Y FF 174772
EXPIRES:March 6,2019
e�
Bonded Th m Notary Public undeners
of Fo,,