HomeMy WebLinkAboutSub-Contractor AgreementPERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to be
(Com aany Name/individual Name);,
the �'��� �6i� Sub -contractor for
_.(.Type of Trade)
(Primary Contractor)
For the project located at �nJ k) Z — 000- Z_ — O 00 ' i-
(Project Street Address or Properly 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.
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CONTRACT -siGiVATIJRE (Qualifier)
PRINT NAME
-SUB -CONTRACTOR SIGNATURE (Qualifier)
-F�JFa pie, IS D g �
PRINT NAME
COUNTr CERTIFICATION NUM ER COUNTY ERTIFICATION NUMBE
State of Florida, County of IV � State of Florida, County of
foregoing instrument was signed before me t day ofTheThe fo ing instrument was signed before me this ay of
204 by C d 0 , 2011, by
who s per ally known or has produced a wh personally known or has produced a
s i tification.Ok- as identification.
AMP � T
Signature of Nota blic Signature of Notary Public
Print Name of Notary Pubr Print Name of Notary u is
B•HUMpHRE`! HUMPHR6Y
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Y V MISSION # 23 v - OI,JpJIISSION #
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Revised 11/16/2016 osF;.•
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PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
i Cy av I-e4Z- �{�-z have agreed to be
(Company-Name/Individual Name)
the UL, Y'?) 1 n Sub -contractor for
ype of Trade)
For the project located at
(Primary Contractor)
3J0_Y1Z-aUa2_- Coo,
_(Project Street Addressor Property Tax ID ff)
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.
CONT NATURE (Qualifier)
PRINT NAME
SUB -CONTRACTOR SIGNATURE (Qualifier)
r:� 'i►: G ti —
,l
�' N
COUNTY CERTIFICATION NUJIBER COLWrY CERTIFICATION ER
State of Florida, County of State of Florida, County of
The foregoing instrument was signed before me this,___JWay of ggpp The foregoing instrument was signed before met is day of
20 by Yaj�i , 20 by ✓
Yis
pe pally known or has produce 4/per Ily known or has produced a C
a
as identification. r1 as ide 'fication.
SignatdYe of Notdfy Public (I V U
y
Print Name oT Notary P t
blic
Revised I I/16/2016
PERMIT# ISSUE DATE
f ri917
(Company Name/Ind
the
(Type of Tfade)
For the project located at
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division .
ame)
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Sub -contractor for
(Primary Contractor)
(Project Street Address or Propert) Tax ID #)
have agreed to be
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.
CONTRACTO GNATURE (Qualifier)
INT NAME
Y
COUNTY CERTIFICATION
State of Florida, County of N, LAC)L U
e foregoing instrument was signed before me thiay of
ho is ovally known _or has produce a� �t
as identification. r�
Signatbfe of Notary Pubrlie I �r v p p
I�ubli�./
Print Name of Notary
Revised 11/16/2016
SUB -CONTRACTOR SIGNATURE (Qualifier)
-:Air)
PRINT NAME
COUN171F CERTIFICATION NUM ER
State of Florida, County of
T going instrument was signed before me this ay of
a �
204, by
pers ally known or has produced a
i