HomeMy WebLinkAboutSubcontractor Agreement I,
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PERMIT# ISSUE DATE,
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division,,
- BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
St.Lucie County Contractor Certification Number:
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State of Florida Certification Number(If applicable): T1 3[7 a g 9 4 ,
►'1 V PP �) C� have agreed to be the
(Company N me/Individual Name)
rlee n- ," Sub-contractor for �,hr,^. � �, c� C°7q Do
(Type of Trade) (Primary Contracto
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For the project located at 110, /u, �y 64r,eA E—r- R,r rev U 3�1'((,
(Protect 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: ,1-4011dwe_ 11- el
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Address: I
City/State/Zip: /20V,1424 AP aC/4 3 3 !V::
Phone: '561 7i g 6.6 77 email:[sJ T L eUa_
E�it���- CT GI�dQ�.� J •®f�c,CGcs cam. I �'� � L ��G
S GNATURE PRINT NAME DATE
STATE OF FLORIDA,COUNTY OF �4. Ly fit t
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS 1'1 DAY OF v ,20
BY &?(:f- Z7iz a"4 WHO IS PERSONALLY KNOWN� ,---OR HAS
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PRODUCED AS IDENTIFICATION.
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IAMON� '� (STAMP
IN COMBeSM#FF 912389 j
SIGNATURE OF NOTARY PUBLIC P d. " �1 Ulu
SLCPDS:08/06/2014
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