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PERMIT# ISSUE DATE
_ PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
•
BUILDING PERIVIIT
SUB-CONTRAC OR AGREENIENT i 41 E }��
LDEC O 9 { g
ST. ucie County, Permitting
have agreed to be
(Company Name It ividual Name)
the Sub-contractor for WJH LLC
(Type of Trade) (Primary Contractor)
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For the project located at 1 ���—� + - f 5s
(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.
�Ij7
CONTRACTOR SIGNAT u itler) SUB- OR SIGNATURE(Qualifier)
S°''2
PRINT NAINIE PRINT NAME
30G �� 3( q14 (c)
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER
State of Florida,County of'_—.!�.(e t .t_� State of Florida,County of GRAN GF
The foregoing instrument was signed before me this day of The foregoing instrument was signed before me this day of
QC3&f� ,20_V'�by�l�G. _fit . . J��-�1. C__)C- 2o\S by Jason James
who is personally known X-or has produced a who is personally known_�L_or has produced a
as identification. dentiflcation.
l
STAMP I STAMP
ignature o o ary Pu Signature Not y ubllicl
Print Name of Notary Public Print Name of Notary Public
KAREND'ONOFRIO Angelique Matthews
MY COMMISSION#GG 237558 °S� s NOTARY PUBLIC
AEXPIRES:AUgust 5,2022STATE OF FLORIDA
•� tary Bonded Thtu Na Public Undefwdters
Revised 11/16/2016 2 Comm#FF958412
s�Nt l �0 Expires 2/8/2020