HomeMy WebLinkAboutSubcontractor Agreement PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
RECEIVED
Building & Code Compliance Division
lI
OUNTY
g P
OCT_0 7 1010
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT Permitting Department
St. Lucie County
have agreed to be
(Company Narre/Individual Name)
the F---ec , y i c ja k Sub-contractor for(Type of Trade) (Primary o/ntractor)
For the project located at l 3 b S L
(Project Street AAdress 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 SIGNATURE(Qualifier) SUB-CONTRACTOR SIGNATURE(Qualifier)
'S
PRINT NAME PRINT NAME .�.
COUNTY C RT CAS-��� CO�IpZ C;ERTIF'� ATIOP�3� �
State of Florida,County of (Cj State of Florida,County of V��
The foregoing instrument was signed
before me this ( day of,,/ The ore ing instrument wassigned before me this day of .,/
l� ,20�1 by-6�1i L� C) [% ,2CW by 1 - /v
who is personally known_or has produced a who is personally known_or has produced a D!/
as identification. as identification.
Signature of Nota ublic Signatu a of Notary Pubiia
KAREN S. :JG
1 o+ � State of Florida KAREN S. NIELSENI•?n�'� •= Commission #otary Publicprint Name ofNota °; My CommissiPrint Name of Notary i Commission # GG 207484 ry o",`�M E ' ! June 12,
Y Commission Expires
June 12, 2022
Revised 11/16/2016