HomeMy WebLinkAboutSubcontractor Agreement PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES,
Building.& Code Compliance Division
a r ,
- -- BUILDING PERMIT
SUB=CONTRACTOR AGREEMENT
71.
�! have agreed to be
(Company Name/Individual Name) f
'the ,i=-( , -�c l e c� ° ' . Sub-contractor for "t' S� Q �,, ' -��
�L
(Type of Trade) a (Primary Contractor)
For the project located at Aocco
(Project Street'Address or Property Tax ID#) f,
It is understood that, if there is any change of status regarding our participation with ithe above mentioned
�tqject,,the-Building-and Code Regulation Division of St. Lucie County will be advised pursuant to the
:filing of a Change of Sub-contractor notice.
_ I is
CONTRACTOR SIGNATURE(Qualifier) SUB OR S1 ATL'IRE(Qualifier)
PRINT NAME PRINT NAME
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER''
'State ofFlorida,.County of State of Florida,County of� LII�CA el
i
The foregoing instrument was signed before me this day of .The fo going instrument was `lined before me this day of
120_t by ,20 byI : A' eV+
who is personally known_or has produced a who is personailyknown orlhas produced a
as idegtificatioP. as entilication. I
STAMP I,f ` STAMP
{ Signature of Notary Public Si n lure Wary Pnblrc
aL i ,". ve,
Print Name of Notary Public Print Name ofVotary Public
fi
; .. �AYME CHEZ
'z MY COMMISSION#FF891926
EXPIRES May 12 21120
Revised 11/16/2016 ��'' i."`
(407]3980153 I` aFloddallo SarviCe.com
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