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RECEIti'=D
PERMIT# \+ �-�$a ISSUE DATE
PLANNING &DEVELOPMENT SERVICES
ICI 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
(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.
CONTRACTOR SIGNATURE(Qualifier) SUB-CONTRACTOR SIGNATURE(Qualifier)
PRINT NAMOE PRINT NAME
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER
State of Florida,County of .LV State of Florida,County of
The foregoing instrument was signed before me this a, day of The foregoing instrument was signed before me this day of
Ales 4{ ,20n by t•��►w eCaa�'ay1 .20_,by
who is personally known_or has produced a who is personally known or has produced a
as identification. as identification.
DEANNAMARIEGIVE NS STAMP
MY COMMM#GG 022023
Signature of Notary Public a, EXPIRES:December 16.2020 Si . ature of Notary Public'
Bonded Thru Notary Public Undew iter
Print Name of Notary Public Print Name of Notary Public
Revised 11/1611016
E I'.' 7 D '•W' 0 2 7017
PERMIT# `,� 1 ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
I Building & Code Compliance Division
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
'J �'�� �E�cZc� have agreed to be
(Company Name/Individual Name)
the 9_0 oIC-L t Sub-contractor for
(Type of Trade) (Primary Contractor)
? �"C'4svviczt+ LVH� A
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.
CONT R SIGNATURE(Qualifier) SUB-CONTRACTOR SIGNATURE(Qualifier)
—>f\L�
PRINT NAME PRINT NAME
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER
State of Florida,County of State of Florida,County of
The foregoing instrument was signed before me this day of The foregoing instrument was signed before me this day of
120__,by
who is personally known_or has produced a 1.O L— who is personally known_or has produced a
as identification. ���5 pti� as identification.
STAMP
Signature of Notary Pu 'c �yGp\re�6 119 Signature of Notary Public
Print Name of Notary Public Print Name of Notary Public
Revised 11/16/1016