HomeMy WebLinkAboutSubcontractor Agreement PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
�� Building & Code Compliance Division
OUNTY At
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
a r 1 have agreed to be
(Co pany Name/Individual Name)
they Sub-contractor for
(Type of Trade) (Primary Contractori
For the project located at
(Project Street Address or Property Tax #)
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) SUB-CONTRACTOR SIGNATURE(Qualifier)
Wi%p- c Swl► 011ie C• Sw��lyl
PRINT NAME PRINT NAME
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER
State of Florida,County of5Lde State of Florida,County off C,
The foregoing instrument was signed before me this ay of The foregoing instrument was signed before me this G day of
20 by--W+) I i C: ',.l J r ,20�,by -Wi
who is pe sonally known or has produced a / '-L
r/
_ P �Y'• � !� who is personally known_or has produced a v )
as identification. as identification.
�3a4�227C'Y�
STAMP4&4TAMP
Signature of Notary u Gc Si ature of Nota P bhc
(=>-h 1A 40 dRaS�Al D F�- v CP - ')JR 1-�)Nxtl
Print Name of Nota Public Print Name of NotaryP lic
F 6 AUDREY B.HUhIPHREY
AUDREY B.HUMPHREY
MY COMMISSION#GG 300817 'r aC
*�
EXPIRES:March 6,
2023 _* *; MY COMMISSION#GG 300817 ioa '
Revised 11/16/2016 lFiideP' Bonded 7hru Notary publicUnderwritors EXPIRES:March 6,2023
Bonded Thru Notary Public Underwriters