HomeMy WebLinkAboutSub-Contractor AgreementPERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
/ y /,A
(Company Name/In ividual Name)
the %1114 Sub -contractor for
(Type of Trade) (Primary ontractor)
have agreed to be
For the project located at `t � 4
(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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CON OR SIGNATURE (Qualifier)
PRINT NAME
n TI
COUNTY CERTIFICATION NUMBER
State of Florida, County of , e I .
The foregoing instrument was signed before me this Aday of
2�by O d1C( !l
who is personally known _or has produced a 1
as identification.
� / STAMP
Signature of Nota a ublic
SUB-bOlVIR VCTR SIGNATURE (Qualifier)
PRINT NAME
01/ 4 .
COUNTY CERTIFICATION NUMBER )
State of Florida, County of / LA,' {G�/
he foregoing instrument was signed before me this / 7 day of
202Vby �-
who is personally known or has produced a j C
as identification.
Ad)aK STAMP
Signature of N ry Public
4�l Y- a- h'P
Print Name o Notary Public Print Name of No ry Public
AUDREY B. HUMPHREY
MY COMMISSION # GG 300817
#; ts' ?y AUDREY B. HUMPHREY
EXPIRES: March 6, 2023 =o .�
F�oP` BondedThruNotary PublicUnderAlers =* *: MY COMMISSION # GG 300817
Revised I I/ /$t��__� o". EXPIRES: March 6, 2023
Bonded Thru Notary Public Underwriters ; t