HomeMy WebLinkAboutSubcontractor Agreement PERMIT# ISSUE DATE
I
PLANNING & DEVELOPMENT SERVICES
Building& Code Compliance Division
BUILDING PERNIIT
SU-13-Ct:3NTitACTOR.A.GREEMENT
fi�f 7— 4--r`?4c-- have agl;eed to be
(Com an Name/Individual Name)
the 1��"" / &2:!:7 ,- Sub-contractor for mP_�P Roftbvr-,A��_
(Type of Trade) (Primary Contractor)
For the project located at. , 1 '�"l.. r � Rm (-CIG
(Project Street Address or Property'T' ITS#)
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
-- - -f7j __ St, cont
Chang ctor notice. - -
CONTRACTOR SIGNATUPE( ,uali0er) SU CO RACTQR SiGNATt1RE(Quali L0
PRINT NAME, PRINT NAME
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER
State of Florida,County of '��K!.��' State of Florida,County oC56dC1e-
_
The foregoing instrument was signed before
before me this
_LO day of The foregoing Instrument was signed before me this 7 day of
r by L 5 f 20�,by �Gr M)
whe is personally known�✓or has produced a who is personally known__,or has produced a
as identification. ( as Identification.
- ... STAMP STAMP
Si- reef Pub[ Signature of Notary Public
lntowe4rl✓ V17Xq
rinl N8m f Nota r Public Print Name of Notary Public
-AANMICHELLE VITALS
CtlmmissWn#FF 235193
- Eltpires duly 4,2019
cr,;,Mtku'i�Fin imr►w( 16t 0
Revised 11/16=16 AOXN Notary PuR}lie;Stmie of Fbdds
Lonatla M Thibault
ti My Commisafon GG 093$`73
�dt4
NT Expirea 08/1012021
5000/2000 12] DNIE I'm maw Lf9L649ZLL Xvd IBJ sT.t 9109fST/TO