HomeMy WebLinkAboutSubcontractor Agreement PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
10 C>;l '"'- Building & Code Compliance Division
FE,,- ',F---, I'P ITTr
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
AUG ?. 1A, 2113P
PER51tIT7ING
St. Lucie COLonty, FL
fv have agreed to be
(Company Na—mdIftdividual Name)
the Elc.c,�-�: Sub-contractor for Ocur►.e✓ /hul lef-�
(Type of Trade) (Primary Contractor)
For the project located at 1-1861 6ta5d fe 1(?--
(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,the Building and Code Regulation Division of St.Lucie County will be advised pursuant to the
filing of a Change of Sub-contractor notice.
+ S
CONTRACTOR IGNATURE(Qualifier) SUB-CONTRACTOR SIGNATURE(Qualifier)
Hn (w• C&no-s Afid(to Cwyi >
PRINT NAME r PRINT NAME I
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER
State of Florida,County of LvG State of Florida,County of e
The foregoing instrument was signed be ore me this �day of The foregoing instrument was signed b a me this 2rday of
20�,by S 20LL by' /
who is personally known or has produced a L who is personally known_or has produced a L
as identification. as identification.
STAMP STAMP
Si nature of Notary Public Signature of Notary Public
--4M"E-xc� �)- s
Print game of Notary Public Print Name of Notary Public
KAREN S. NIELSEN KAREN S. IIELSEN
��
_" Commission ti FF 115637 i
Commission N FF 115637 ?* *_
_
S = My Commission Expires ��y a; My Commission Expires
9� '9r L`F f�
'�•,,;aFf\�o` June 12. 2018 „°;:�`'� June 12, 2018
Revised 11/16/2016 "—