HomeMy WebLinkAboutSubcontractor Agreement PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
a I
y�y BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT I
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y/� ,��e A/Ire have agreed to be
(Compffiy Name(Ind'vidual Name} ��j d����
the � Sub-contractor for t ��rl
(Type of Trade) (Primary Contractor)
For the project located at ; ,o illc
(Project Street Address or Property ax ID#)
It is understood that, if there is any change of status regarding our participation with the above mentioned
project,the Building and Code Regulation Division of St.Lucie County will be advised pursuant to the
filing of a Change of Sub-contractor notice.
NATURE ualifier) SUB-CONT CTOR SIGNA aikfier)
PRINT NAME PRINTNAME
30._;_)VK
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER
Q�"/t__ /
State of Florida,County ofck State of Florida,County of��U'C�t
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The foregoing instrument was signed efore me this C ay of The foregoing instrumenjt�was signed before me t ' day of
2�___� Y t 24___ 1
ho is personally known_or has produced a _ who is personally known, I or has produced a
a identification. dentification.
STAMP STAMP
a ure of No Public Signatur of o a Public
HAu
Print Name of otary Public Print Name of Nota Public
At, `�OtPRV F'(ig�~ ANGELA M HUFF
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�PRYF'Ggi~~ ANGELA M HUFF * ;c+S Notary Public-State of Florida
c �~: Notary Public-State of Florida -
�NCommission FF234730 N.w ; Commission#FF 234730
i��OF F4�p'� My Comm.Expires May 27,2019 ~~%FBF FLa4O,�. Tdy Comm.Expires May 27,2019
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'" " Bonded through National Notar Assn, `
Revised 11/1612016 Bonded through National Notary Assn.I? - 4 y