HomeMy WebLinkAboutSUBSPERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
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have agreed to be
(Company Nanie/Individual Nale) I 1
the '--'
V rY� Sub -contractor for � 0 � �1 r .d.-r
(Type of Trade) (Primary Contra tor)
For the project located at �551 1 �O fixofnl(A
(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 SI TURE (Qualifier)
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PRINT NAM
OW-1
COUNTY CERTIFICATION NUMBER
State of Florida, County of , We ( C-
The foregoing instrument was signed before me this day of
, 20Y�l/I f W V v IG
who is pe nally known _�!4r has produced a
as i nti ca ' n. __ Jjk'�_' STAMP
!;'Kture of Notary Public
Print Name of Notary Public
Notary Public State of Florida
Christine A. Marsh
+� p My Commission HH 026766
�i dF Expires 08/02/2024
Revised 11/16/2016
SUB-CONTRACTO GNATURE (Qualifier)
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PRINT NAME
q-3-�'r. (
COUNTY CERTIFICATION NUMBER
State of Florida, County of L~�
The foregoing instrument was signed before me this I day of
201, by 'Vt tLN w m
who is personally known Y-'or has produced a
as identification.
LA'��
�
SiknffurCof Notary Public
Print Name of Notary Public
a
llotary Public State of Florida
Christine A. Marsh
My Commission HH 026766
Expires 08/02/2024
STAMP
I
the
PERMIT #
ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
rcc A if- Ee%2i
(Company N me/Individu
C% tC,4t—
(Type of Tra e)
For the project to
It is understood
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
�00�er7` �ci yu lC
Name)
have agreed to be
Sub-contractorfor podi" 6 �fe'e7.
C
(Primary Con actor)
at
(Project Street Address or Property Tax ID #)
if there is any change of status regarding our participation with the above mentioned
project, the Buildi g and Code Regulation Division of St. Lucie County will be advised pursuant to the
filing of a Change f Sub -contractor notice.
1 C 2�\/ tk7
PRINT NAM
02�-3 -?l
COUNTY CERTIFICATi
State of Florida, County o
The
/foregoing instrument
20_a
who is personally known
-
as identification.
Signature of Notary Publi
i 1�%N m)l'�
Print Name of Notary
Revised 11/16/2016
NUMBER
it C ct
signed before me this day of
r} has produced a _
COUNTY CERTIFICATION NUMBER
State of Florida, County of�_�
The foregoing instrument was signed before me
this day of
C C— 20%by {JI
who is personally known - or his produced a
as identification.
STAMP = STAMP
Signature of Notary Public
A i��
Print Name of Notary Public
u
v $��� Notary Public State of Florida
n
A Thomasina Bowins
GG 201733
"a'
My Commission
ExpiresO03/2912022
400eyr P Notary Public State of Florida
A Thomasina Bowins
±y „ .� My Commission GG 201733
Expires 03/29/2022
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