HomeMy WebLinkAboutSUBSPLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
(Company Na e/Indiv dua( Nart�e)
the � lyg r� ��//
(Type of Trade)
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
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have agreed to be
Sub -contractor for p o � � � i. f .
(Primary Contra tor)
For the project located at :1 6b l& h C \0 Q0 Z V t/� W
(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.
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CONTRACTOR SIG gCQ.Aiffiwr�
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PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County off 't
The foregoing instrument was signed before me this _ day of
D_ 20 Dby ' PYPYf
who is pers natty known _or has produced a
as id tific ti
STAMP
Signature of Notary Public
Uln-'-'V�m WW,5�-' -
Print Name of Notary Public
(Yfill;
� Notary Public State of Florida
Christine A. Marsh
My Commission HH 026766
Expires 08/0212024
Revised ll/16/201
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SUB -CONTRACTOR S ATURE (Qua frier)
PRINT NAME
d i 1
COUNTY CERTIFICATION NUMBER
State of Florida, County of `, u'X-A
The foregoing instrument was signed before me this & day of
200� byT i �,
who is personally known �or has produced aroduced a
as ide ifi lion.
STAMP
Signature of Notary Public
Print Name of Notary Public
a
llotary Public State of Florida
Christine A. Marsh
My Commission HH 026766
Expires 0a/02/2024
Pa
the
PERMIT #
(Company N
C166l
(Type of Trac
For the project lol
It is understood th
project, the Buildi
filing of a Change
CONTRACTOR 15,Al
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PRINT NAM
a�3 -?/
State of Florida, County a
The foregoing instrument
,a
who is personally known
as identification.
Signature of Notary Publ
Print Name of Notary Pu
Revised 11/16/2016
ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
T2)C1K0OLer7'
ividual Name)
tC'}(_
70ayu k
have agreed to be
Sub -contractor for /000l Q L � t2 e _
(Primary Con actor)
at 161) 5C�- AddUO VA
(Project Street Address or Property Tax ID #)
if there is any change of status regarding our participation with the above mentioned
and Code Regulation Division of St. Lucie County will be advised pursuant to the
Sub -contractor notice.
I�aL�
vas signed before me this day of
�by,
Cor has produced a
SUB -CONY T SIGj °TUBE (Qualifier)
0ff e d Q
r y u k
PRINT NAME i
COUNTY CERT FICATION NUMBER
State of Florida, County of1�
The ffooreego�ing instrument was signed before me this'- day of h
— U/20-Z by Lit--
who is personally known Yor has produced a
as identification.
STAMP
Signature of Notary Public STAMP
Pnnt Name of Notary Public
s3 Mn
Notary Public State of Florida
A Thomasina Bowins
MP , Commission GG 201733
Fa ' Expires 03/29/2022
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PlotarY Public State of Florida A Thornasina BoWlns
of cod
MY Commission GG 201733
Expires 03/29/2p22
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