HomeMy WebLinkAboutSUBS-- PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
(Company Na e/Individual Na e)
the S,) VYI Sub -contractor for
(Type of Trade)
For the project located at
have agreed to be
� C V'. Y Y
(Primary Contra tor)
(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.
CONTRACTOR S N TURE (Quali ter
Ffr\i e
PRINT NAM
�a �;_
COUNTY CERTIFICATION NUMBER
State of Florida, County of U �C:t (L
The foregoing instrument was signed before me this A2 day of
, 20 R, by
who is personally known X-or has produced a
as iiiwdifiication.
Signature of Notary Public
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Print Name of Notary Public
WEi
tate of Florida
arsh
HH 026766
Revised (t/l024
l
SUB-CONTRACTO I ATURE ualifier)
i L� fi
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of C
it, u''i $
The foregoing instrument was signed
/before
finee this -a day of
20mby 1�a V1 UV 1x,
who is personally known '�-_or has produced a
aidtiffication.
STAMPSTAMP
gureof Notary Public
m m&m wyv�m
Print Name of Notary Public
a
lf
Notary Public State of Flonda
Christine A. Marsh
My Commission HH 026766 Expires oa/02/2024
Y
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the
PERMIT #
(Company N
C-Lccl
(Type of Trat
ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
e T2;iC1'Kober7-
ndividual Name)
tc- AL
For the project looted at
It is understood
project, the
filing of a Change
C
a.�3 -)I
UNTY CERTIFICA
State of Florida, County
The foregoing instrument
11 209
who is personally known _
have agreed to be
Sub -contractor for /00d) -Q 6 � 2 e - e.
(Primary Con actor)
1, ` 1 -11 a� anal 10 f
(Project Street Address or Property Tax ID #)
if there is any change of status regarding our participation with the above mentioned
and Code Regulation Division of St. Lucie County will be advised pursuant to the
Sub -contractor notice.
)N\NUMBER
� '
vas signed
before me this,1� day of
by f e �'kA 1N\C
<-or has produced a
as identification.
Signature of Notary Publi STAMP
t Name of Notary
s ie�` Notary Public State of Florida
Revised 11/16/2016
^ A Thomasina Bowins
My Commission GG 201733
4, � Expires 03/29/2022
SUB-C rr T TO IGNATURE (Qualifier)
PRINT NAME
98 yf
COUNTY CERTIFICATION NUMBER
State of Florida, County of
The foregoing instrument was signed efore me this M day of
_-, — ' 20 a by
who is personally known �" has produced a
as identification.
T-0 g : STAMP
Signature of Notary Public
Print Name of Notary Public
n Y <� Notary Public State of Florida
A Thomasina Bowins
L- e My Commission GG 201733
�ovs Expires 03/29/2022
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