HomeMy WebLinkAboutSubcontractor Agreement �`t2�•goi •p�3�•�
PERMIT# SLC- 20000" O&U ISSUE DATE t//S/120d
PLANNING & DEVELOPMENT SERVICES
COUNTY Building & Code Compliance Division
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
f f 0 ujz-.5' , /t �. 4Z-J41 have agreed to be
(Company Name/IndividualName)
the 4�2�1 2 Sub-contractor for-JCw
(Type of Trade) (Primary Contractor)
r_
For the project located at 97� C3GCf� •7J ��
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.
e
qCTRAeCTOR SIG ATURE(Qualifier) SUB-CONTRACTOR SIGNATURE(Qualifier)
PRINT NAME PRINT NAME
C o00 /
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATIO _R
State of Florida,County of CrWState of Florida,County of
The foregoing instrument was signed before me thisX day of The foregoing instrument was signed before me this�day of
2bY ,24),by
u M4.S•r \t
who is personally known_or as produced a v who is personally known_or has produced a 1'L iX iU Q!s
identification. as id�J'ication.
STAMP 6'/ r � STAMP
!,,.t
n t f Notary Pub Signa a of Notary Public
Name of Notary Publ" Prin ame of Notary Public
li"A
*= MYCC�IMISS(p r R�1NM(NG
EXPIRES.�eCe�#GG275Q60 ;:A, �ii`• PHYLLIS ANN WANNA
Onded r20,202' :: • r:
Revised 11/16/2016U=m Thru 2 �• Notary Public•State of Florida
Notary public Undelvn 4'Titers
a
;• T° Commission p GG 364193
My Comm.Expires Aug 8,2023