HomeMy WebLinkAboutSubcontractor Agreement �'T
ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
b BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
have agreed to be
(Company Name/Individual Name)
the 4 Sub-contractor for
(Type of Trade) (Primary Contractor)
For the project located at "� � Y�P e
(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.
i •C
CO RACfOR SIGN (Qualifier) SU RA SIGNATURE(Qualifier)
166
PfdNT NAM! PRINT NAME
COUNTY CERTIFICATION B,/EAR COUNTY CERTIFICATION NUMBER
State of Florida,County of — l�L State of Florida,County of -4. " C --7
The foregoing instrument kas signed before me this day of ` The foregoing instrument was signed before me this 5� day of
20 �' ,by 1�-��' I� ODD ,IG.. ,2017,by (.AIJ,
who is personally known_or has produced a ✓ who is personally knowgor has produced a
as identification. as identification.
STAMP '2 STAMP
Signature of Notary ublic nature of Notary Public
KAREN S. NIELSEN _
Commission N FF 115637
fission Expires �P�rSC'�1
Print Name of Notary Publi :use o June 12. 2 01 8 Print Name of Notary Public
hnm"
Inl
JASON M RAULERSON
Notuy PUNIC-State of Florida
Revised 11/16/2616 Commission 0 FF 965546
My Comm.Expires Feb 28.2020