HomeMy WebLinkAboutSub AgreementPERMIT # ISSUE DATE
the
(Type
For the project located at
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to be
Sub -contractor for OU 1 fyie
Contractor)
(Project Street Address or Property Tax
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.
s`lL ;1, H
COUNTY CERTIFICATION NUMBER
State of Florida, County of
The foregoing instrument was signed before me this 29 day of
Dte.. ,20_Wby SWJtWrl Otlmo�
who is personally known /�or has produced a
as identification.
STAMP
nature of otary Public
J ae- cuo t
Print Name of Notary Public
�d `' OW. Notary Public State or Florida
`F Jaclyn F Wilson
y • My Commission GG 275464
W or w Expires 11/08/2022
Revised 11/162016
SUB -CONTRACTOR SIGNATURE (Qualifier)
t c)nni.(—,, Cud "�Yl
PRINT NAME
A414% / RF i 10673-D-
COUNTY CERTIFICATION NUMBER
State of Florida, County of Ka 0i , ^)
The foregoing instrument was signed before we this 2a day of
QJLr_ ,2020, by )_'r)r D C_L'_IYJ.CiG.7i.B
who is personally Imowu.--� or has produced
as identification.
STAMP
Si re ofNotKYPubric
Name
Notary Public State of Florida
Jaclyn F Wilson
�Jv ` My Commission GG 276464
0, n4� Expires 1110812022