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HomeMy WebLinkAboutSub-Contractor AgreementI —
PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGRRFMIENT
J , I Gl& �C-h` I 4 j'6 i) �"�� have agreed to be
(Company Namellndividual Name) l
the f r ( 4YI Ca - Sub -contractor for 1'VZ H . FL LL.C.
(Type of Trade) (Primary Contractor)
For the project located at 7 ©©L% Petrnu 1_n 301 - LD L I ' 0190' < (jdrIN
(Project Street Address& 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.
GGG is17458
COUNTY CERTIFICATION NUMBER
state or Florida, County of -s f`Q.+c
The foregoing instrument was signed before me this rday of
fi 114 13,51 2a_0by�i1 CC:r 1'tti !DC's.tom_
who is vrsoaauv kaawn or has produced a
as I�deennstricattiion..
STAMP
Sigdature orNolaryPublic
.Heatto- c7uhiin
Print Name or Notary PAW,
FittaCirr C O=�
s3pmw 0 Alaian ttrt Q2DtO
eat
WOM
Revised I1/I620Iti'
COUNTY CERTIFICATIONNUMB Pun
Stated Florida, County of Ind{ I _
The roregolag instrotnent wan signed before me this I sday of
L LSt]St 111E _, 2Q, by V l�7
who Is plersonatly known or bar produced a
SAMANTHA STANFORD
=:o•J �f�'s
_� *c Commission M GG 48974
;1 .a My Commission Expires
November 20, 2020
rn na
STAMP
PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
One Stop Cooling & Heating LLC / Zachary Boera
have agreed to be
the Mechanical Sub-contractorfor V1JD_H ' FL LL.C.
(Type of Trade) (Primary Contractor)
For the project located at i 004 Pert-( L.PV--,0__ 13 C 1 ( p- 11 • ©18w' OLV =2:_�
(Project Street Addres 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 SIGNAT :�dl
o.
PRINT NAbIE
GGG 151-1458
COUNTY CERTIFICATION NUMBER
State of Florida, County of f`P
The Foregoing instrument was signed before me, this 3 day of
who Is persoMkA!21wn orhas produced a
as Identification.
� A 11 . STAMP
SignatoreofNotory' Public
+4ebat -ex Era, l in
Print Name of Notary Pehik
¢ 1101si� Pkt>tMe Slw d'PitttU
j ►tit tt�wo
wf�
Revised I I/I6/2016
9UB-C 'OR SIGNATURE (Qualifier)
Zap ry Boera
PRINT NAME
CAC 1817652
COUNTY CERTIFICATION NUMBER
State of Florida, County of ORANGE
The foregoing Instrument was signed before me this 16th day of
September .i0�0by ZacharyBoera
who is personally Imowu X or has produced a
as Idendticado .
STAMP
Signature of N
Kelly Ashlock
Print Name of Notary Public
Kelly Ashlock
*C611P
NOTARY PUBLIC
STATE OF FLORIDA
Comm# GG969901
Expires 4/4/2024
ti •
PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
agreed to be
For the project located at -700 L--( Pe!2i.P , L owi p , � 3 01 - Lgl l ' 01 Z�7 ' ©QC' j'
(Projeat 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.
CONTl3ACTO[tBIGNA�� edl T
w
PRiN7'NA1HF:
G.GG IS Q 45$
COUNTY CEWMCATION Ni1MMIt
Stala•of Florida, County of`$-�+�•►pl
The fora¢o iw((umenteaa t8,}
Wg shoed h�ore_mo4hls�daydr
AJOqUal
who Ia rsb atnown _or bas produced a
osldenfifceafion.
y+CJtE AA-4 STAMP
STAMP
Signature oLNolagTifte
foe' C1ft0' - hi in
Print Nuae'or Natory..PuDJf,
1��e t� pyr10 Q111rd Plgdir;
- HtMI!ltar C OMrYt .. _
• •, yjy eta AsIon NNoli0010
Revised 11/16/2016
/VA
v
P.81NT NA W
CCG 13- 1,2g0,
COUNTYCSRTIFICAMINI MMIRER
State of Florida, County, of cu
The foregoing hoftsomtwas signed Won me i1ds1N &y of
hy�j�r"�y
wYo b personalty Mown has produced a
as ldendlleation.
STAMP
SigatureofN P Ile
Print Name orNottiry Public
`''"hNotary Public State or Florida
Yesenis PeraBe
My Commission GG 251702
Expires 00122/2022
PERMIT#
ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
► CAZLL-Lt ' have agreed to be
(Company Na e/ludividual Name)
the ` l ug " J N �'� Sub -contractor for k'�/ rH " �� LL.G
! (T a of Trade) (Pn—.7 Contractor
i )
For the project located at 7oO Lf 61, L J 2DI ��_ ©lx
j (Project Street Address Property Tax ID #)
t
It is understood that, if there is any change of status regarding our participation with the above mentioned
project, the Building and Code Regulation nivision of St *
filing of a Change of Sub -contractor notice.
r
"
GG 15117L#
State ornorids. County of
Tihe (arNMIng Instrument was signed before me this 6o, _ d y or
209
who is persuaa� —or has prodwmd a
STAMP
�M� Waliry �riMk $Itlb d fhdh
+r FiMtlw C DnttW►
i. V 1 Cp1MYyi{11t t�IFt QZYQ/Q
Revised t!!16/2016 'i/
f
1
WWI
G' C(' :
COUNTY CERTIFICATION NUMBER State of Florida, County of rd he foregohtg instrumtat was signed
�� before m//]] e this `9 I day of
2Q,& by L02 it CD ho&
who ersonaily flown or has produced a
de Eeadon.
STAMP
' afire of No ry P Ilc
I )11
Print Ns or Watery Public
ppa4% CINDY ROSSWURM
I
? Notary Public -State of Florida
`i Commission p GG 937520
My Comm. Expires Dec 5, 2023
Banded through National Notary Assn.
PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to be
(Company Namedndividual Name)
the (Vo 516# A an 6&CI "di Sub_contractor far %AJZ7 t' _ FL, LL C.
(Type of Trade) (Primary Contmetor)
For the project located. at D D q Pennw L c)bv j , ► 301 • (e C I - D l �S�• 0 4
(Project Street Addres r 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.
G&C.151-45lo
COUNTY CERTffICATION NUMBER"
State of Florida. County of A! f`adrQ
The fortgolnr Instrument was sigotd befure me this � day of
who IstrsanaUy:knowa
—
or bas produced a.
naft �
as'Idetttifiatioo.
STAMP
Signature of Notary Public
f4eci .r pahi in
Point Naive of Notary Public`
. fMtlrr Pvwe soft oil Fit"i
titMlttM C OMllln
`MvMr Caetnuwon HH 020of0
Emit"09oMM
Revised 11116I2016014
sui-cowraccrok SI ATURrrE..(Qus intr)
ZQ�U��Q:
PRINT NAME
COUNTY CERTtRCATION NUMBER
State of Ftortd@, County of n
The
as
was Ji*td before ate this ` day of
_• 20_,
inMolva
i� '�� IDUFR30 �f DJah"i=
NctaryPublie State ''.criEe
Cer rrtssian f !u o-ev:J
anJ *Carr.ExpirosA,.-.2"'2D-r4
Sorded through Nations!+e;;Iry kv.
STAMP
M
•
PERMIT #
C+
COUNTY
F L 17 R I D A
4! ebde
ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to be
the G" CG1 * C+& Sub -contractor for 1�0%
(Type of Trade)
(Primary Contractor)
For the project Located at'7 04 "I
eat
(Project Street AddresYor 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.
. C. 1st 7 451
COUNTY CERTIFf@a17ON NUMMIt
State Of Florida, orsteemsA
The foregoing Instrument was signed before me "V1 d y of
by A&M=e. _ !'frs r ice► __
who L+I erso . Imown_or has produced a
as Identification.
STAMP
Signature of.Na�ry Public
Print Name of Notary rave
t+Iplf:�F;Ift sw 49Phltt#
Htralltar C QdiYn
E GannJbsioii � Noma
4
Revised 1 U16/2016
44
SUB -CONTRACTOR SIGNATURE (Quall1kr)
PRINT NAME
COTJNTY'CERTIFICAT[ON':NUNIHER
State ofNortda,County of t�n RJver
The foregoing instrument `vas signed before me thb t day or
by i'l f Ck I �/l L S
who is personouy Imown V . or has produced a
as a don.
Sii -off Notary Public STAMP
t 1 �"�"L"*IG
Print Name of•N ft-ft
piy TIFFAN`! L F:Notary
Notary Public . da
` Commission. t
My Comm. Expir024
Bonded through Natiossn.
FERMT
I# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
r Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
LLCJ
have agreed to be
the SJ Wim[.Vl Sub -contractor for VV H T7L L-L.G
(Type o Trade) Q (Primary Contractor)
For the project located at-70nLf Penhi4 I_-o" , ) 3 Ol • (d 1 . G 18_7• 000'
(Project Street Addrcss'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.
GGG !BI-] L 68
COUNTY CERTIFICATION NUMBER
State of Florida, County of
s}
The foregoing imtrument was signed before me this 5v day of
who 1s perfonnl� ly !n _or bas produced a
as identification.
STAMP
Signature of No Wry Public
+q0Q_i*M Da,h l i n
Print Name of Notary Publle
trouttr vYOrc sort. of plot+.
ti�lttr► C t)M�Ytt
(E>O�a tMi OZDOte
Rovised I I/Itirzot6
01
SUB -CONTRACTOR SIGNATURE (Qualifier)
kiybn. Kuhn
PRINT NAME
COUNTY ERTI1 CA ION NUMIIER
.State of 4WINOanty orPJW+5
The foregoing instrument was signed before me this IL day of
,
who persountiy known Zor has produced a
as Identification.
STAMP
Signat roof otaryPublle
a, AAau-w-
Print Name of Notary Public y
"A MA2U'�����i
V,ISSION' 9 �j
JAN. 9t
PERMIT # I-SSUE DATE
PLANNING & DEVELOPMENT SERVICES
•
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to be
Sub -contractor for. ,:YH * 'FL LL.C.
(Primary Contractor)
For the project located at `7 d O q I( e,r k2Lt_4 1_ e Q,- 13.01. LID It • © I%q - d 0D
(Project Street Addres Propeity Tax My'
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.
GGG 15i7 L4518_--
COUNTY CERTWICATIONNI ER
Shttc•ot Florida, Couaty of�Q�,trpi
The (arggd!0g iasl 0Megt wo# llgaed bctara mo't4ts.° day, oY
A11gLs�� m arm- by - l►��.,� �� r, , - "�
who Is ersonrilly--kaow�u ____or has produced a.
(�
as Idendrieadon.
STAMP
Slgoalure orl4otgry, P.yh1tp:
Prat Nome of:Notory Pahllc -
py�c 81pa d EMiMti ;
t�.wtkt
Cpriyaion:tiM G70610
Revised 11/16/2016
kA
S CONTRACTORS( ATURE(Quoter)
PRINTNAW
COUNTY -CERTIFICATION NUMBER
State of Florlda, County of
Th foreeoing ins u?en� he ore qe hisAk�yf
f
ICU _ _ fD'
who Is pera try lmowa or has produced a• .
L
,01 Notary Public State of Florida
Brittany L Rubino
•My Commission GG 2n878
or nod' Expires 10/28/4022
PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB-CONTRACTORAGREEMENT
have agreed to be
WO-H ,1'z LL.C:
(Primary Contractor)
For the project located at 70OL4 L.aTy p-" 1301 • U . 01157
(Project Street AddrbA 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.
,C&C. 151-2458
COUNTY CERTIRCATION NUMBER
State of Florida. County of: svC+!M0K
The foregoing Instrument was signed before me this day or
j� gig L161 . OAgby tAA C=&)—!D>'ft�tG
who is .. known_or has produced a
asIdendficadon.
I_At STAMP
Sfgnatare orNotaryPdbIIc
CA&I.C7- 1*�579—f
COUNTY CERTIFICATION NUMBER
State of.Florida, County of
q
The foregoing instrument was signed before we this I day of
2613by --xn 1 HAYly
who Is personally known ✓ or has produced a
as Identification.
1 V ` STAMP
'Sign0turt orNotary Public
APRIL M. HAR"
Pilot Name orNotary'Public- Print Name ofNotoryPobli ;,. ,:r_Nry IS$=#GG19V68
�. EX ikm March 16.202Z
6
• c of /lurk i jM1,,• Bonded n. NoWy P-Wk tlMemft-
' tltlp;Con_anllror,tMl R29C10
E_,pYirtwoa102s
Px*cd I1/16/20I6
COUNTY
F L O R I D -A
PLANNING & DEVELOPMENT SERVICES
Beilding & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to be
(Company Nametindividual Name)
the C' CX.),r o. Sub -contractor for• W—, " H , FL LL.C. . .
(Type of Trade) (Primary Contractor)
For the project located at 740 q D('nV�>✓1 404-x , 1301. it • Q 1 OW-4
(Project Street Aor 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.
GGG, 15,1145$
COUNTY 'CERTiFICATION NUMBER
'&ate otl+lorida,:Cgmtyaf
reeelasitntiivmeaCwu�slEaed hefore me ttiis;�day..of
who .Is'tr E!e M or has,prodased a.
( asidentifrcatlam
JR�U L% lit �! STAMP
Sigaatare ofNotary Pohl,
Print Nam of Notary Pcblic`
liatary tsYble stela al t?lu iY
40Y..
P"im C DM iN.
wy Cain>irioer.ilN:Ofa
�«ErOi!w"tNi06�Qd
Revised 11116201& A]
S GTo s TUBE(Qi ,1&r)
PRINT NAME
cecbc;o36D
COUNTY CERTIFICATION:NUMBER
State of Florids, County of 46 11sbD_,eovSk
The foregoing instrament wassiaoed befam nee this. day oft
2U V by AA&en I Ll�°P�r,tdd lC /
who is persanoUy lmowa or has prodwc a
asldwtlilcadon.
` STAMP
Sigaator Notary Public
Print Name of Notary Public
E(OhtNotary Public State of Florida
Merri lou 5hankwitz
My Commission GG 283557
Expires 02lt212023
PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to be
(Company Namalludividual Name)
the /4'ewr1 716 .FA&7W-4 Y'i6A]r— -Sub-contractor for Vq--7--{ ' .FL. LLG
(Type of Trade) (Primary Contractor)
For the project located at "7CCq Pehn- u LLZ nQ ( 3 0 Lai 1 .01182 000-2-
(Project Street Add 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.
G&G 1517456
COUNTYCERTiFICATION NUMBER
Sime,of Rtortdq, County dZeeemrd
1
The fa[egotae.Inslromentwss ftlned before me tliis,6�any:or
who Iszrs m �r hu produced a
as Identification.
LlQ
9ienstare of Nomry FabUc
f4&Qfiyer EXLk ,1,j'n .
F&Nzi ifnobry Emig
Sue-cat�Ttt,�cT SIGNATURE (Qnauner)
pA1ti>B�
COUNTY CERTIFICATION NUMBER `� �� /�
State of Florida, County ot�1f(..u' `2l
The forepin inetrumentwar st before me tbb U `day or
y t1t' � t
who b p�own or bu produced a
tineaeloa.
STAMP Ip
of Notary PhtiB .
1116111"mow
0.d p �� a4e Notary Public State of Florida
Brittany L Rubino
- • My Commission GG 271878
�et�' E~�»d� Expires 10/2812022
Revised t l/ 16201 ti
PERMIT:#:
ISSUE DATE
COUNTY
F t O R I D A
the
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to. be
Sub -contractor for .! —TK '. FL L_!_.C.
(Primary Contractor)
For the project located at -7Q Lt Rey)Y114 ,. 13(j6. iQc.f - 01 gq' '020-�
(Project Sheet Addles Property : Tax ID
It is understood that, if there is any change of status re
garding-obr 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.
COUMT CERTIFICATION NUMBER"
State:of Ptorido;'Coonry. of
IS Theioreg-fthufthtenrivossipaed. fare *thb3lf day of
who b rein !mown ur has prodoxed a
as idwi.doo.
STAMP
Slgnstare or taryPg6lk
PsidENnme of tYotory EnhH`
PttMe 1t1tAr i! Fltytli
t;ElN.t>g06/0
F�Ie1F0a108�
4.,
Revised 11116/7.016
"'M
±i CHIFA t11:7: 017A I 1 i i
PRINC Ni1lVIE _ � _. _
S+ Us-a'O.- a4 I
COUNWCERTIFICATIONNUMBSR nn ^n
State of Roridi, County of O I�Cl:.PItJrL 1J�.X..
The foregoing huhvment won signed before me thb dry of
:off �rtar► I .LQ
Who h perm known or hm produeed a
u ldeatUlotitlom t A
LORYA EDWgRDS
., MY COMMISSION GG 078W
A
,`•' EXPIRES: May 7,102
Bonded ft Notary P1�6e 1
lhMenml¢B
PERMIT # I I ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERBUT
SUB -CONTRACTOR AGREKM3 4T
/,,�/io/7
have agreed to be
the 1, sU la moo„ Sub -contractor for W,7-H ' J=i- L L.C.
(Type of Trade) (Prim" Contractor)
For the project located at -7 M LP n j= f 1301- L (I • Dl 54 • DOD:J
(Project Street A or Property Tear 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-conaactor notice.
GGG 151.1451
COUNTY CERTWICATION NUhWJt
State of Florida. County of zcemenrpr
The foregoing astrement was stened before me tbts>L d y of
A fig 11,51 •20�gby %ACCC41 -004 4
An V penoasllr ka1 or has pnodoad a
tt u I,den��tjlfinllon.
STAMP
signature orNotoryPubtic
+4ebC1'ti�l" fah 1 t!1
PdAtNAM of Notary Patdlo
r wasi„owksoar,wp.
tv � tw mgo+o
w
Revised I Ulfif1016
[ AAAA
PRM NAME
NZ - /SO Ll
COUNTY CCELTWICATrox NUMBER
State of Florida, Coanq orzff t 6
The foreptug lasbrotnest Sna dgeeed Ohm ate this day of
A0114.2 y �JL� Yl Tulle
Who Is pm nNq liamm _der hu prodneed a
R
NotaryPublic State of Florida
Brittany L RubinoMy Commission GG 271879
Expires 10/28/4022
WN-W PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB-CONTR.,ICTOR AGREEMENT
GALE INSULATION have agreed to be
(Cotnpatty Nameiindividuai Name)'
the INSULATION Sub -contractor for WJH FL LLC
('type of Trade) (Primary Contractor)
For the project located at -7C-0q pin L.pi,r�, J'q pl . Ie t 1 D) 9-7 'Coo
(Project Street dress 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.
GGG 151-1'45$
COUNWCERTIFICAnON NU%MER
State of Florida; County of Z rr-91" 11
The foregoing instrument was signed before me this 5Tday of
20:-- 'by OACq 144!DC')d IL'f—'
who is ep2akknoz
____.or has -produced a
as identification.
-'��►tJ1 %% �L �� STANIP
Signature of Notary. Public
+4eQ�J_ F�a.hI in
Print Name of Notary Public
�. too" Pubk SON of Brut
,��blip ComMW@ian HH t1MO
!:>oitis0005r2024
Revised 1111612016
COUNTY CERTIFICATIONNVURER
State of Ftorids, County, of L-6Z
The foregoing instrument was signed before me this day of
September 20 Za , by lhak W , t4sk
who is personally known _1f/ or has produced a
t „Y•,,. JENNIFER MET
• NotaTy ic-StateoWoOda
Commission A GG 50011
ocn ,,a My Comm. Eaplaes Jan 29, 2021
STAMP
PERMIT # ISSUE DATE
....... . . ..... J
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Jam+ _� C- nX0_Cg,, ��cas - L have agreed to be
(CompanyName udivi I Name)
the !; GO rctt_ c%C.x5 Sub -contractor for ' t�tt `�-t. FL LL.C,
lftype o de) (Primary Contractor)
For the project located at`100 q Pey) nu l.eLr)p13�) .c 2.L I 0) 0'Z • alb , T
(Project Street Addr6A 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.
ol�
CONTRACTOR SIGNATU er)
s\A,o
PRiNTNAME
GGG 1517'-E5$
COUNTY CERTIFICATION NUMBER
State ornorida, county of t Pax" .
The foregoingla}tiumat igas dguedberamme tsts'34:0Y. of
who Is ersoaal known _or has produced a
as identification.
ld A. Lem �J STAMP
Signature of 3+[otay P.uptio
Print Name of Notory Public
� rtel�y Rit>ir SIfOa d'itatir.'
I' t4eafliw G C1titMi�►
lilfit CatittiMaoq:Hllt pZ00t0
E�piiw tlttttiSGtC2a
*,qt�
Revised 11/16120le . .
SUBCONTRACTORSIG"NA (Qualifier)
LrVA (:. C, ^GEC—e_
PRINT NAME
30z 1
COUNTY CERTIFICATION NUMBER
State of Florida, County of _
The foregoing instrument was signed before me this 14day of
28 by.CAQrC , .
who is personally known ✓or has produced a,
as ldentifiention.
STA6IP
Siguature of Notary Public �rt
Print Name of Notary Pablik
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