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PERMIT # ISSUE DATE i
PLANNING & DEVELOPMENT SERVICE
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
h
(Company Name/Individual Name)
the��P c f f''� �'G % Sub -contractor for
(Type of Trade) , (Primary
For the project located at
or Property Tax ID
have agreed to be
It is understood that, if there is any change of status regarding our participation with the above mentioned
III
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.
C NTRA - O SIGNATURE (Qualifier)
PRINT NAME
SUB -CONTRACTOR SIGNATURE (Qualifier)
PRINT NAME
COUNTY CERTIFICATION COUNTY CERTIFICATION,]
State of Florida, County of State of Florida, County of
The foregoing instrument was siggtQeogre me this da of �j The foregoing instrument was
20by `^�\ 1 , 20L_, tiI
who is personally known or has produced a ULC7 who is personally (mown
as identification. as identification.
4�
STAMP
Signature of NotargPublic Signature of Notary Public
Prin Name of Nota Public _ _ , Print Name of NotaryPublic
��au.",., A ANGELA M HUFF
pRY Ppe.,� ,�,
Notary Public - State of Florida Commission ## FF'234730
I:
My Comm. Expires May 27, 2019 ,�
Bonded through National Notary Assn
Revised 11/16/2016
before me this day of
has produced a
STAMP