HomeMy WebLinkAboutSubcontractor Agreement I
PERMIT# ISSUE DATE
t -- PLANNING & DEVELOPMENT SERVICES,:l ram.
Building & Code Compliance Division R f
s - -- BUILDING PERMIT JUL 9 5 �
SUB-CONTRACTOR AGREEMENT FE hlUl I?7i NI G
St. Lucie County, 1=L
ACCOM7_6 L -reum I GJT" /rll C 1AoW)R 6A5L f- ) AI have agreed to be
(Company Name/Individ -'Name)
—- the_ �LECT/��c�l Sub-contractor for .S fed Z-o�Z It, (� 'Vet• k4 I2c"��/�fR /Af
(Type of Trade) - — - —(P-rimary-Contractor)____
For the project located at / Z 3" / ^.j z�--rr L t-s 3 Y i S '7
(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.
CONTRACTOR SIGNATURE(Qualifier) SUMONTRAAOR SIGNATURE(Qualifier)
-QZ t (-lf r•+,r-n IA&,Jdt YLk1T—", �/�T (0� 6J(;6L1\17dAfA1
PRINT NAME PRINT NAME
CC CW-W7a
COUNTY CERTIFICATION NUMMER COUNTY CERTIFICATION NUMBER
State of Florida,County of • LU(4g, State of Florida,County of , q
The foregoing instrument was si ned before me this�day of— The foregoing instrument was signed-before me_this /day_
20J,by / 20a by atif t-L_
who is personally known or has produced a (,. who is personally known.,A_or has produced a
as identification. as identification.STAMP C
Signature of-1 —� Signature of Notary PublicE C.
i 'Vl��d/�9
Dorise C. Virailio ��mber2�Efp
Print Name of Notary Public Print Name of Notary Public
A NFFOM192 J��
KAREN S. NIELSEN ,9
� y= Commission# FF 115637 �rs,'o(�'.'JbrcUoetl
My Commission ExpiresSTATE,�F.°:''
Juno 12, 2018 IIf
Revised 11/16/2016 III!
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