HomeMy WebLinkAboutSub contractor agreementPERMIT #� �J G�✓� -- ISSUE DATEImo-
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
v
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
�OL\1'0 r Xc- V F�h��� � have agreed to be
(Company Name/Individual Name)
the `( w� ti Sub -contractor for oc"r pt", 'C'," °---
(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 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
20 7-0 by 61 C/ A O I V l� 20_, by
who is personally known -A/—or has produced a who is personally known or has produced a
as identification.
as identification.
— hymp��k_ STAMP STAMP
Signature of Notary Public Signature of Notary Public
4
0ALl"01"'. ;&aw'fe
Print Name of Notary Pubic Print Name of Notary Public
EIT,
BIANCA FATHAUER
otary Public - State of FloridaCommission # HH 044164
y Comm. Expires Oct 6, 2024
Revised 11l16/2016 through National Notary Ann.