HomeMy WebLinkAboutSUBSPERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
t` f
have agreed to be
(Company Nar4e/Individual Na
e) t
the m Sub -contractor for 9 g 5'6r 1 r
(Type of Trade) (Primary Contra tor)
For the project located at 140(A 9`ft D�
(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.
r
CONTRACTOR S1434TURE (Qual' ier)
Te,rl W 1 4
PRINT NAMME
a�3_ (
COUNTY CERTIFICATION NUMBER
State of Florida, County of 0 C
The foregoing instrument was s�ed before in, this _a day of
2Q,bby
who is personally known --6r has produced a
as identification.
i nature
of Notary Public
Ar e
Print Name of Notary Public
SUB -CONTRACTOR SIG URE (Qualifier)
PRINT NAME
DS 3_ (
COUNTY CERTIFICATION NUMBER
State of Florida, County of C
it,tom(
,The foregoing instrument was signed pbefore� m1,e�thgis� —_ dray of
,20�by :Y VV 'Wti Y�
who is personally known_y__or has produced a
as identification.
STAMP C'� } 42)tz,�_
Sigeure of Notary Public
Print Name of Notary Public
,,n ►, JOANNEWILLS
,. A Commission # GG 272813
'•"� , e •' Expres February 20, 2023
k Mad TIn T Feln Insurance $00,94W7019
Revised 11/16/2016 ray
STAMP
JOANNEWILLS I
.. *; Commission# GG 272613
Expires February 20, 2023
Bonded Thor Troy fain Insurance e00.3e5.7019
15
Pit
the
PERMIT #
(Company N;
C-�6ei
(Type of Trat
ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
e 72)CIkoo1,er7`
hdividual Name)
t C ,4 (—
For the project loc4ted at
I'ayu%
have agreed to be
Sub -contractor for {000) n 6 fee .1 e
(Primary Con actor)
(Project Street Address or Property Tax ID #)
It is understood th , if there is any change of status regarding our participation with the above mentioned
project, the Buildir g and Code Regulation Division of St. Lucie County will be advised pursuant to the
filing of a Change of Sub -contractor notice.
CONTRACTORS]
1 C (2R
PRINT NAME
State of Florida, County c
The foregoing instrument
20a
who is personally known,
as identification.
Signature of Notary P
A
Print Name of Notary
Revised 11/16/2016
(Qualifier)
vas signed before me thisi111 day of
by —�—
or has produced a
/ 98 yq
COUNTY CERTIFICATION NUMBER
State of Florida, County of y�t
The foregoing instrument tvas signed before me thisl� day of
NIN
who is personally known —)!;r has produced a
as identification.
STAMP -- -�'` % STAMP
Signature of Notary Public
Print Name of Notary Public
nw N;G
^
Notary Public State of Florida
A Thomasina Bowins
hoc
My Commission GG 201733
Expires 03/29/2022
c►o'
0101.0
101 n0iitf Nota=80wins
orida
A ThMy C733Ex,ir