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Sub-Contractor Agreement
PERMIT # �A � ©�L �j ISSUE DATE PLANNING & DEVELOPMENT SERVICES Building & Code Compliance Division BUILDING PERMIT SUB -CONTRACTOR AGREEMENT RECENItD NOV g 2 1010 Permitting Department St. Lucie County Fn��ec� �aF�n ha Ae agreed to be (Company Name/Individual Name) the �A"Z- C)KI Sub -contractor for (Type of Trade) (Primary Contractor) For the project located at `% f( rC�/1 ►� •t (Project Street Address or Property Tax ED #) 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. Cgi4TRACTOR SIGNAT Qualifier) PRINT NAME COMTY-CERTEFICA71ON , State of Florida, County of The for going instrument was signed kefore me this of U 2 by len, who is personally known _or has produced a as identification. j STA Si natur Notary Pu lic Print Name of Notary Public KAREN S. NIELSEN SpPY PUB B�i 'a° `psState of Florida -Notary Public p _• *_ Commission # GG 207484 p� �OF ��` My Commission Expires June 12, 2022 Revised 11/16 S -C TRACCTOR SIGNA URE (Qualifier) Kcj4b I-e elm � PRINT NA1VIE CO Y CER IFI AT ON ER State of Florida, County of'�fC. Thi2v oing instrument was signed b, re me this y of ,2QN� by who is personally known _or has produced a as of Notary Print Name of Notary Public KAREN S. NIELSEN 3a° `pl=State of Florida -Notary Public =' 'c Commission # GG 207484 °'i�O�� My Commission Expires June 12, 2024