HomeMy WebLinkAboutSubcontractor Agreement (2) i
PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
: COUNTY
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
_ o-rne,s have agreed to be
(Company NameAndividual Name)
the P�urn 6-, ,c, Sub-contractor for
(Type of Trade) J (Primary Contractor)
For the project located at 2 l e-I — D,3 , 000 I —o00 3
(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 f Sub-contractor notice.
CO CTOR SIGNATURE(Qualifier) SUB-C NTRACTOR SIGNATURE(Qualifier)
' GMa..s
PRINT NAME PRINT NAME
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER
State of Florida,County of State of Florida,County of 4
The foregoing instrument was signed before we this—Iiday of The foregoing instrument was signed before me this day of
200'4 by ��hA-VIP C,- )�1)40 6-D)A) 2029,by C)
who is personally known or has produced a )C who is ovally known_or has produced a
t
as identification. as identification.
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STAMP
Signature of Nota ubfic Signature of Nota Public STAMP
CA t;, O'blum` ->4 �J —4�Dc-ti! - M-Yn Cpl) tr Il
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Print Name of Nota Public Print Name of Notary P lic J
AUDREY B.HUMPHREY ;o<`Y?�a�•. AUDREY B.HUMPHREY
-1 " MY COMMISSION#GG 300817
GG 3
COMMISSION# 00817 '*' *` EXPIRES:March 8,2023
*: MY =ma
*' EXPIRES:Match
Revised 11/16/2016 6,2023
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Bonded Thru Notary Public Undenxritors
dThru Notary Public Underwriters
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