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ISSUE DATE
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PI, ING &DEVELOP SERVICES � II
Ra' din & Cade Cam mance Xl�'tvisian
W"ING PEW UT
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SUB-CONTRACTOR AGREEMENT
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It1�v4:agteed to bi ,j'
(C N e/fn t W N e)
the Sub-contractor for
(TYP; £ e) (Primary Contract
For the pro# c, ted at , .207
(Proji at S xcet Address or Property'fax ID#)
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It is under4c d h;4 if there is an cis ge of status regarding our participation with the above mentioned
project,.the I h ii) i.g and Code Rel ulion Division of St.Luci County will be advised pursuant to the
Min a Ci ' f Sub-contractor n tice. E
C 7f CTORi T FRE(Qualifier) 6tt dmiUCTOR SIG An=(Qualifier)
PRINT NAME ; P NA?M
CtIUNTY CBRTJ F1 TI * R Co CERT)P•ICATION NUM ER ,
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State oYliloridis, � u oS� Stu aS7Florlda,County of1 ,.:.-._ � I ��
The foregoing im u t - s signed botoro wet is day of The foregoing instrumeit was signed before me this�daylof I�
tile by ( ZOby r ttli
who Is personally I ar has produces a• who#S persaually tc�uawn or bas produced a !
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Widen ation. i as idi atiftcatlon.
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STAW STAMP
sigoa re of Nota a 110 atery c
1, HYN DEYANNF ,J_ � E
PrintN of u ie-a t o PrWtrmtofNotaryPablic
mis9lon IN Gd 944 30
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Revised 11116/2016 BohdedlteuNCA�fi u+�
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PERM IISSUE DATE
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MAPS NING&DEVELOPMENT SERVICES
ui ding& Code Comp' ance Division
RUR.AING PE
SUS-CGNTRA.CTQRAG EMENT
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Nexgen Piinsihave agreed to be
(Co N' /Individual Name) I
the Plumbin� Sub-contractor jor Joe Holland
Me o ) (primary contractor)
For the proi ClIcatedat9940S can Dr Jensen beach A f 4957 apt 207
( roj ct S et Address or Property Tax #}
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It is underst'o da,if there is any ch,- ge of status regarding cur participation with the above mentione,,d
project,the I i and Code Re 'on Division,of St.Lucig County will be advised pursuant to the '
fili f a o f Sub-contact z �a txce, ;
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x A ; (Qnat3Oee) U�-CO BxGNATURE(Quallfler)
oe Hoilan Harryson Arroyo
RRM NAME I PFJW NAME
COUNTY cmT11 TTN NUMBER CO TV CEIYI'TI+mCATION NUMBER
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State of Florida,•i o m y q -t T stat aP�+loounty of
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The foregotug i nt i ras signed betbre we I its 1 day of 'c6 lGrregoinz instrumcat was signed before nae tWs / day oil
v u i z R" zo ay-- (arryS0��
T
D r Lc-
who Is personal i a n --Cps prodaeed a wbq is personat� y Irndwn or has produced a pY t 4
lip Ideatmeatliam.11 I a iQ elk
S�.AMP STAMP
Stgnature of ojr3 Pblic of Notary Pub'
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Print Name ofNl to ry Futiis w \r\5S10N�p ®% AName oi'Natm7 Public .Go �BE N" ;J�'
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Revised 11/16/20 6 lPme6 UBLIC,•S�(�sL �,�w�
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