HomeMy WebLinkAboutSubcontractor Agreement PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
ti(J ga— 6--K(a have agreed to be
CompanyName/Individ al Name)
the y�c� ri GSub-contractor for
(Type of Trade) (Primary Contractor)
For the project located at 5#F f RW: J`' /::L
(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.
CONTRACTOR SIGNATURE(Qualifier) Al SUB-CONTRACTOR SIGNATURE(Quali rer)
PRINT NAME VPRINT NAME
INI;�: N14 .
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER
State of Florida,County of (,(�C`� State of Florida,County of
The foregoing instrument was signed before me this Y day of The foregoing instrument was signed before me this Ly—day of
Zo, ,by I AJ A h UCs 1 ,20,q,by W�y)+)1eA_ h
who is personally known or has produced 1(:.. who is personally known or has produced a
as identification. as identification.
adnW M- & �31
STAMP TAMP
Signature of Nota ubhc Signature of Notary Pu c
Print Name of Notary P Print Name of Notary ubli J J y
AUDREY B.HUMPHREY
1::Y P(j• OOMMISSION#FF 174772
�..B(��i""
*_ MEXPIRES:March 6,2019 AUDREY B.HUMPHREY
rite tiaAY.dye',
=_°' `"` MY COMMISSION#FF 174772
Boomed Thru Notary Public L'ndz w rs
=* t" EXPIRES:March 6,2019
zrwr ters
Revised 11/16/2016 "'% o;` Bonded Thru Dlotar/Public Und