HomeMy WebLinkAboutSUBS PERMIT# ISSUE DATE
z PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
P_QXC&� C-7fCZ have agreed to be
(Company Na e/Individual NatT�e)
the .�aa
V tY� Sub-contractor for �t-
(Type of Trade) n (Primary Contra tor)
For the project located at 9-[b2 YXY)i Na Z Y
(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 SIGNA URE(Qualifier)r SUB-CONTRACTOR SI TURE(Quali,e
PRINT NAM PRINT NAME
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER
State of Florida,County of Sk Ls. A C State of Florida,County of ( c
The foregoing instrument was signed before me this � day of The foregoing instrument
was�ensigned before men this � day of
20 ,by_ l — J 20/I,byl ' f W 1
who is personally known Yor has produced a who is personally know nor has produced a
as identification. as identification.
STAMP STAMP
Signature of Notary Public Sygnature of Notary Public
Print Name of Notary Public Print Name of Notary Public
+r�tiW
,�AYPG ,• JOANNE'WILL8 ava(;a;, JOANNEWILL9
' ' ° .Gommisston#GG 272813 �,�Commission-#GG 2726t3 -
's �� Expires Februanj 20,2823
-,� •�. "�. P;' Expires February 20,2Q23
Revised l 1/16/2016 FO ptYQ'• Bonded Thai Troy Fain insuranoe 800385.1019 f op v Bonded Thru Troy Fain Insurance 8A0.385.1019
PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
1C O b er7`- lzh��v 4 have agreed to be
Company Name/Individual Name)
the jE- ` CCTrelc,4 L Sub-contractor for ! od -< b �re e p �
(Type of Trade) (Primary Cont actor)
For the project located at
(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.
4.
L-P-9
CONTRACTOY IGNATU (Qualifier) SUB-C r4 CT6 IG URI(Qualifier)
PRINT NAME PRINT NAME
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER
State of Florida,County of , State of Florida,County of
The foregoing instrument was signed before me this
1 , day of The foregoing instrument
was signed before me this � day of
- ,20�1,by V V v,jG 20 U b by l—
who is personally known or has produced a who is personally known\�4or has produced a
as identification. as identification.
� A
I�
STAMP 9-`—f ` - STAMP
Signature of Notary Public Signature of Notary Public
h�Lo�m
Print Name of Notary Public Print Name of Notary Public
,V PO
� Notary Public State of Florida
A Thomasina Bowins �K��° see No4ay703/�2'9/2022
of Florida
c , ate My Commission GG 201733 ^ A Thowins
Revised 1 I/16/2016o`ndY Expires 03J29/2022 jr k. My Co 201733
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