HomeMy WebLinkAboutSub-Contractor Agreementss A
PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to be
(Company Name/Individual Name)
the /! p_c4 r ; r ,� Sub -contractor for 0'kn r 1 "- Pro 1J Ix
(Type of Trade) (Primary Contractor)
For the project located at /Q 0e) S :C SCNA,j P I uer- Dr -
(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.
""4k, /x
CONTRACTOR SIGNATURE (Qualifier) SUB -CONTRACTOR SIGNATURE (Qualifier)
C' hnrlre PrdJ/Jc
PRINT NAME
(�ioQ'k �) ems
COUNTY CERTIFICATION NUMBER
State of Florida, County of "� LU Ct(
The foregoing instrument was signed before me this / day of
20: by cl a e-P R-0 V
who is personally known _or has produced a L as identificatio C -
11
� ST
Sig( %"
nature of Notary Put ,
Print Name of Notary Public
KAREN S. NIELSEN
[1—
�;State of Florida Notary Public
Commission # GG 207484
My Commission Expires
��°ii June 12, 2022
Revised 11/16/201
l__. ^ r fig 60r) ✓ 4
PRINT NAME
l�
COUNTY CERTIFICATION NUMBER
State of Florida, County of
The foregoing instrument was signed before me this H day of
20_` by C* ailV 'PrOU IX"
who is personally known or has produced a_ D
as identificati
AMP TAMP
ignature of Notary Pubh
Print Name of Notary Public
11M
EN S. NIELSENFlorida-Notary Publicission # GG 207484mmission Expiresune 12, 2022