HomeMy WebLinkAboutSubcontractor Agreement PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
W'q 7-yes have agreed to be
(Co pany Name/Individual Name)
the / ' ) C Sub-contractor for
(Type of-Trade) (Primary Contractor)
For the project located at o?0D 1?1Q 1A- 9,Q Lc) JC,
(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.
CONTRA R SIGN TUBE(Qua 1/her1�) UB-CONT OR SIGNATURE/(Q1ualifier)
014E_P,\1L_ &6e-IL L-
PRINT NAME PRINT NAME
129 s.
COUNTIV CERTIFICATION BER COUNtY CERTIFICATION NUMBER
State of Florida,County of State of Florida,County o
YIQN foregoing instrument was signedbefore me this day of '�
oregoing instrument was signed before me thL day
�o(fLA
�
kyal 20 by f//� 1 20 by � V�7 9his-
Y °Tpersonally known or has prod ced - I C w o is personally known_or has produce
as identification. as identification.
STAMP ?AMP
Signature of Notary P HE Signirture of Notary is
V1 Wo C",i53. )�Lk/YkR 196� �r_A !�X� - �1 I& ry) kA
Print Name of Notary Public Print Name ol"Notary1rumic
IAUDREYB.HUMPHREYCOMMISSION#FF 174772 "i''•- AUDREY B HUMPHREY
Revised 11/16/2016 XPIRES:March 6,2019 += MY COMMISSION#FF 174772
d Thru%tary Pubrio Underwriters EXPIRES:March 6,2019
^ Banded Thru Notary Pubric Underwriters