HomeMy WebLinkAboutSubcontractor Agreement, HVAC III
PERMIT# 4 ( ^ ISSUE DATE
o - 6
PLANNING& DEVELOPMENT SERVICES
•i Building &Code Compliance Division I
•
BUMDING PERMIT
SUB-CONTRACTOR AGREEMENT
i
i
e have agreed to be
VyNa minie ividua Name)the Sub-contractor farof Trade) (Primary Contractor)
For the J ro'ect located at
p M
(Project Strut Address or Prop Tax MA
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((Quaiile r SUB-CONT CTO IGNATURE(Qaallfier)
PRINT NAME PRINT NAME
t�
COUNTY CERTIFICATION N' R COUNTY CERTIFICATION NUMBER
State of Florida,County of State of Florida,County of C WPM
The regolag instrument was signed bef me this day The foregoing
r f regaing Instrument rrae signed before this f -0a of
20_4 b, �wYUCS�f
wha is p nally known Vor b p dueed a who' ono yB` known— or has produced a
as idea tion. as id illation.
STAMP STAM1 _
SivAtureefNataxyPublicSignature of Notary Public
Print Name of.Notary Public Print lame of Notary Public
Notary Public Slate of Florida Not"Pubk St a of Raid.
. My coFnc s Donza Karon F Lamb
�d My commission 0-112 12 21 092440 ' i K Cnawd011 HH Ot152bi
i:xpUes 0712T12821 NOV �py�1 ilit024
Revised 11,16 2016
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