HomeMy WebLinkAboutsub agreementPERMIT #
COUNTY
t t G E. L f,
cOle_ 03.5 V Y, I ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to be
(Company Name/Individual Name) i f 1
the I1t 4#J Sub -contractor for J. U1f�S (m
(Type of Trade) (Primary Contractor)
For the project located at 63 120Z,1 Jv%i
(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.
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WN
CO CTOR SIGNA Qualifier) NrRACTO I A (Qaamer)
PRINT NAME PRINT NAME
COUNTY IIMCATION NUMBER
state Or County of n
The for ing instrument was signed before me this 6 - day of
28_=y I 115�
who is personalty Imown or has produced a
as identification.
14e o otary Public
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e
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Revised 11/16/2016
STAMP
4ffC CSC 13 5
COUNTY CERTIFICATION NUMBER
State of Florida, County of SA-L' (-'
The foregoing instrument was signed before we this 19J day of
zox by y\
who is personally known ,6Or has produced a
as identification
STAMP
Signature of Notary Public
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Print Name of Notary Public � QNp M. GORNz�//,��
zo GOGG WAW'
i a� eo�ded Mt`��om�•' ���
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