HomeMy WebLinkAboutSubcontractor Agreement PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division RECEIVED
ilCOUNTY
BUILDING PERMIT DEC 3 ® 2010.
SUB-CONTRACTOR AGREEMENT Permitting Department
St. Lucie County
(\Njrne��V) f"r have agreed to be
(Company Name/Individual Name)
the_ NA i,,,,�p � Sub-contractor for
(Type of Trade) (Primary Contractor) /
For the project located at 1 �-
(Project Street AddreA 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.
Q . OLD
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CONTRACTOR SIGNATURE(Qualifier) SUB ONTRACTOR SIGNATURE(Qualifier)
C. ee12 �. Sep;co �eL e«� � I CQom_
PRINT NAME PRINT NAME
n P.V_-] (22) 11�' 1& all n rc- � ANI, 1JP'
CO CtRTEFICATIOIV VMER)n COUNTY CERTIFICATIO4' '
ER �(19State of Florida,County ofn - '3�� State of Florida,County of
State E,
The foregoing instrument was signed before me this V day of 1 The foregoing instrument was suzued before me this day f e�oi ,
2�by Sei 1,) ,2�+by �1W
who is personally known_or has produced a who is personally known or has produced aL�
as identification. as identification.
AME STAMP
Signa ure of Notary ublic Signature of Notary Public
Print Name of Notary Public Print Name of Notary Public
4Y PV�� KAREN S. NIELSEN KAREN S.
e�cState of Florida-Notary Public =°sue Ue'=State of Florida No alrSpUblic
Commission #GG 207484 =� Y
= a9, °,r; Commission # GG 20748
9�F ° My Commission Expires - F P�• M 4
June 12, 2022 ''�°;,;�°`` Y Commission Expires
Revised 11/16/201 June 12, 2022