HomeMy WebLinkAboutSubcontractor Agreement PERMIT# ISSUE DATE
,- PLANNING & DEVELOPMENT SERVICES
t - Building & Code Compliance Division
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` BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
have agreed to be
(Company Name/Individual ame)
the X- Sub-contractor for
(Type of Trade) ,� (Primary Contractor) U
For the project located at��" '— 1 Q' ��, �- 3 I `�l �Z
(Project Street Addres or Property Tax ID#)
;I.
iIt 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
fling of a Change of Sub-contractor notice.
1/R14 2 n� ��� �° J
TRACTOR SIGNATURE( alitier) S CONTRACTOR SIGNAT (Qualifier)
PRINT NAME PRINT NAME
R. (9 W-k( e).2
COUNTY CERTIFICATION NUMBER) , /► COUNTY CERTIFICATION NUMBER
J�..//State of Florida,County of 4. li c( State of Florida,County orz—
.foregoing instrument was signed before me this/�day of foregoing instrument was signed before m�eetthis�day of
2tM /,by U off/ IV (5'— 20p,by J-1 ) ! ) d �
o is personally known_or has produce � /� ho is personally known_or has produced
`'�u\l ,
as identification. as id tificatiou.
-41
STAMP STAMP
aftXnatureofN t ry Public ) ), Signature of of ublicj
Print Name of Notdry P—ulilic Print Name of Notary ublic
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AUDREYB.HUMPHRE'- ���"i''' AUDREYB.HUMPHREY
MMISSION4FF17477%. MY COMMISSION#FF 174772
EXPIRES:March 6,2019 s; a- EXPIRES:March 6,2019
Revised ll/16/2016 •``' Banded1hriNotaryPubficllndenvrtars `.
BondedfhruNotaryPubl'wUnderwriters
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