HomeMy WebLinkAboutSubcontractor Agreement PERMIT# I n t� Q ) �,� ISSUE DATE
-- - - -- - PLANNING & DEVELOPMENT SERVICES
14�1�� rBuilding & Code Compliance Division
COUNTY
t
• R I D A BUILDING PERMIT RECEIVED
SUB-CONTRACTOR AGREEMENT
JAN 2 8 2020
ST. Lucie County, Permitting
A, ti, 2to `�' -(�(i have agreed to be
(Company NarnJindividual Name) D
the 4 `A Sub-contractor forIV eft W , 'T� )lJJ °D N
(Type of Trade) (Primary Contractor)
For the project located at
(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.
cbNTRA.CTOR SIGNATURE(Qualifie SUB-CONTRACTOR SIGNATURE(Qualifier)
elz L� . RO Ai ()-AJ 2tc144 - � '(N C
PRINT i AME PRINT NAME
COUNTY CERTIFICATIONN NUMBER , P COUNTY CERTIFICATION NUMBER
State of Florida,County of `\�.\UVI v �� State of Florida,County of 5 �^
The foregoing instrument was signed before me thisQ1�1day of The
The foregoing instrument was signed before me thisJ�/ day of
20gkby��r �-(,SiR 101`1 ,2020bY �L W
who is personally known_or has produced a V v who is personally known or has produced a
ASign
tification. as identification.
STAMP l• STAMP
lure of 1o�ta is Signature o tary Public � '
Zrbo
Print Name of Noiary Public Print Name Af Notary Public
6ROOKE M.STETSON �,+> HOLLY NICOLE Kt1Lr"
o4 °ate Notary Public,State of Florida . +
_ " Commission#GG 922964
Revised 11/16/2016 Ny'COmm.a%pireS Oci.15,2023 e�Fa�°�� � &