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PERMIT# / ISSUE DATE [
PLANNING &.DEVELOPMENT SERVICES
Building & Cade Compliance Division
�._ ....M BUILDING PERMIT
SUB-CONI TRACTOR AGREEMENT
C-
have agreed to`be
(Company Name/Individual Name)'
the l- C T, P,.cam—t Sub-contractor for J4 ..C' . c.0?�v S-T.-W C' iJ
(Type:of.Trade) (Primary Contractor)
For the project located at 7��1 t.--—a �A cJVO- f - 'l r~ i ed'`C
(Project Street Address or Property Tax ID#)
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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) S,'B-CoN RACTOR Si I ATURE(Qualifier)
PRINT NAME PRINT NANME
- l0ZA P 0
COUNTY'CERTInCATIOI NUYIBER COUNTY CERTIFICATIOa. 'UMBER
State of Florida,County of 6N_t t' State of Florida,County of L
The foregoing instrument was signed before me this day of, T .
a foregoing instrument was'signed before
�metlils .day of
1 tN., 201-7,,by F
who I ers�i Ily known or has produced a w s'P!Pr
s Hall mown r has produced a
as idea`fication, as i' n ication..
AL? STAMP
Sig t x of Notary Public Signature of Notary P Iie P
ff—iON:I FF'074311
Print Name:of Notary Public ,3Im EXPIRES:December 22r 2017 P-rinf game o i�lotary blic
'�.R'!t•' Donded,Tft, PubNcUndesw+?en
ANGELA M HUFF
r Yt Notary Public-State of Florida
' lZ Qommission#FF 234730
My Comm.Expires May 27,2019
Revised.1 111 612 0 1 6 I R3+ Bonded through National Notary Assn.
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