HomeMy WebLinkAboutSubcontractor Agreement PERMIT# ISSUE DATE
� s V FIR � 9 PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
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r
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
�� ss have agreed to be
Sgol3paq Name/Individual Name)
the ll. 1 n Sub-contractor for
(Type of Trade) // (Primary Contractor)
For the project located at `f— ���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 Su -contractor notice.
CONTRALTO SI ATURE(Qualifier) SUB-CO RACTOR SIGNATURE(Qualifier)
PRINT NAME PRINT N
N /_— -
COUNTY C RTIFICATION NUMBER COUITY CERTIFICATIONNUMaERState of Florida,County of v State of Florida,County ofct-e-
The oregoing instrument was signed before me this day ofry; The foregoing instrument was signed before me this�day of r ,
20) by l?- erl v� �1�.��/ d�Qi� ,20L,by �C' y
who is personally known_or has produced a &A who is personally known or has--pliuced a L
as identification. as identification.
STAMP & MP
Signature of Notary P is Sig ature of Notary lie
I&r) y
Print Name oaf Notary P blic Print Name of Notary P rblic
AUDRO B.HUMPHREY
firs..Y, tr>n°Y•.
,itiZ' AUDREY B.HUMPHREY
i-PYMY COMMISSION#FF 174772 :
Revised 11/16/2016 =*: EXPIRES:March 6.2019 ers *' * MY COMMISSION#FF 174772
�= ru Notary Public Under writ EXPIRES:March 6,2019
�Ff3fF Bonded Th p.f.0"' Bonded ThruNOW Public Underwriters
PERMIT# ISSUE DATE
T--- PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
•
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
have agreed to be
mpany Name/Individual Name)
the C/ ��e G4 r- ) C Sub-contractor for
(Type of Trade) (Primary Contractor)
For the project located at ��/� "4,- - (-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-c ractor notice.
CONTRACTOR SIGNAT ualifier) UB-CO IAACV0R SIGNATURE(Qualifier)
es'] ry) • t4,e'r'r&
l
PR NT AME PRINT ME
COUNTT CERTIFICATIONNU COU Y RTIFICATION NUMBER
r r
State of Florida,County of " .- State of Florida,County of _
The foregoing instrument was signed before me this�day of The foregoing instrument was signed before me this�day of
201 by �Il� �La�J� ,20,L by / /1
who is personally known_or h pr uced a - who is personally known or has Orad/red a (�
V11 U
as identification. as identification.
AMP / AMP
Signa ure of Notaryblic Signature of Notary ub is
0
► � �1�t�mm - P _� �'
Rte • r� ze
Print Name of Notary bli Print Name of oto Public x
�
°� r"Gb•• AUDREY B.HUMPHREY
MY COMMISSION N FF 174772
EXPIRES:March 6,2019
Revised 11/16/2016 tiwAUDREYB.HUMPHREY + .
MY COMMISSION 4 FF 174772 p;;;tF'• Bonded Thru Notary Public Underwriters
EXPIRES:March 6,2019
%sPf doe Bonded Thru Notary Public Underwriters