HomeMy WebLinkAboutSubcontractor Agreement PERMIT# ISSUE DATE
PLANNING &DEVELOPMENT SERVICES
Building & Code Compliance Division
COUNTY
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
have agreed to be
(Company Name/Individual Name)
the Sub-contractor for
(Type of Trade) (Primary Contractor)
For the project located at i4 v e— Q FJ pcey-e e- I�1'1 3 cj 1 SU
(Project Street Address or Property Tax ID,#) 0 o v- O
It is understood that, if there is any change of status regarding our participation with the above mentioned
iproject,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 TRACTOR NATURE(Qualifier) SUBCONTRACTOR SIGNATURE(Qualifier)
PRINT NAME PRINT NAME
I
0 13 y�
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER
State of Florida,County of a State of Florida,County of,
The foregoing instrument was signed before methis day of The foregoing instrument was signed before me this '� day of
20�by��W 1 1S I ,20J by
who-is personally known_or has produced a who is personally(mown_or has produced a.
as identification. as identification.
I Oe'� STAMP STAMP
Signa�r ,-M.1sixy Pa c Signature of Notary Public
KAREN S. NIELSEN
Commission# FF 115637 \\,\II�11�11//,
9 o• o4"Poblimission Expires Prin iOarE$ ¢,(iF pssion# FF 115637
°; June 12, 2 01 8
,; =
My Commission Expires
?:;°,;; �•''• June 12. 2018
i
Revised 11/16/2016