HomeMy WebLinkAboutSubcontractor Agreement PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
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BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
have abrccd to be f
(Company Name/Individual Name) �— S3 mrm
the E,t o c+t t C&A Sub-contractor for WSJ UX� &Q,( Sat es s� L
(Type of Trade) (Primary Contractor)
For the project located at ZgOS 9Adet &mm-o&V- Land '�-Ork- Wce ! - 'tq"1(31
(Project Street Address or Property Tax ID 0) ;
It i understood that if there is an change of status regarding our participation with the above mentioned
s , y � � za P p
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.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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CONTRACTOR SIGNAT E(Qualifier) SUB-CONTRACTOR SIGN. URI;((JuaGlier)
NS
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PRINT NAME PRINT NAME
fi2-C t. 32'755 31�8� C 3boS45S
COUNTY CERTIFICATION NUNIBER COUNTY NN NUMBER
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State of Florida,County of y�(__ State of Florida,County of-
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The foregoing instrument was signed before me this t day of The foregoing instrument was signed before me this 1 day of
D" 20—.gby nk _,20-uby r
who is personalty known or ha roduced a wh "s personally known_�_or has produced a
aside titicad as iden cation.
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STAMP S'CANIP C
Signatur'`of Notary P biic Sign ture of N F `tanry,,Pu-b tc
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Print Name Of Notary Public ��.�GN XM s10 y4` PrintNameo Notary Public \\,.SG AI
Pd�PUBLtC9ryNAp'�r 8[lC ti• ZZ
Revised 11/160016 4;,
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