HomeMy WebLinkAboutRoof SubPERMIT# 1ZZl01 - O� V ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
MI-OCI(orsn Kooffm I Shut ti
(Company Na e/Individual Name)
the R N4; %A Sub -contractor for
(Type of flhke)
For the project located at
I, • have agreed to be
J-d e
(Primary Contractor) 1 ldL�
1"-211- Rol- 000.1)
(Project Street Addresgor 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.
CO TRACTOR SIGNATUR Qualifier)
INT NAME
C UNTY CMTIFICATION NUMBER
State of Florida, County of
,+he foregoing instrument was signed before me this day of
, Z041 by L�� Cd &/
who is personally known or has produced a
as identificati .
aL
STAMP
Signatur of Notary 4ublic
Print Name of Notary Public
gig
State of Florida
n GG 920786
/2023
Revised 11/16/2016
SUB-CONTRACTOIR SIGNATURE (Qualifier)
Mrc�a�l R �IaGK � Presiole�f
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of tldtan IVC r
The foregoing instrument was signed before me this day of
20�. ,by M1t,hlitl A hjfAL,�
who is
as
Signature of Np ary Public
LOt
Print Name of Notary Public
produced a
111
��
Notary Public Stato of Florida
Leslie Brown
y
or
My Commission GG 920786
Expires 10/08/2023
a
STAMP