HomeMy WebLinkAboutSub-Contractor AgreementPERMIT # I I ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
(Comp ny N e/Individual Name) /��
the �e Sub -contractor for z_`_�
(Type of Trade) (Primary
For the project located at
;2_5_2�
have agreed to be ,
(Project Street Address or Property Tax ID #) -3 �7
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 9IGNATURE (Qualifier)
' Z��
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of 5 JL_ 1..y
The foregoing instrument was signed before me this J0( day of
B-CONTRACTOR SIGNATURE,(Qualifie )
#/,,- f�: v
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of S•r Li fl glc
The foregoing instrument was signed before me this day of
20� by 20__, by
who is personally known or has produced a who is personally known _or has produced a
as identific)lion. as identification.
r=='W, 0 A t6 I AMP A& A do STAMP
Sin are of Notary Public ign ture or11&aryKbHc
NIELSEN
Print Name of Notary Piu �`,�\y pie%, Notary o � .State .11 of Florida -Notary Public Print Name of Public
�^
_. ►: Commission # GG 207484
9 a? My Commission Expires
June 12, 2022 y
KgRE
►= C to of F orida NIELSEN
` My Corn ion # G� �07g84
Revised 11/16/2016 dune !scion Expires
12, 2022
PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to be
(Com ny Na /Individual Name)
the /,4t,1i Sub -contractor for
Type of Trade) (Primary Contractor)
For the project located at
)—f, z- 0 e! � nle , -,
(Project Street Address or Property
ID #)
3C/�%1,f,
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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C NTRACTOR SIGNATURE (Qualifier)
w�
RINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of
The foregoing instrument was signed before me this day of
, 20_, by
who is personally known or has produced a
as identificati n.
Signature of Notary Public
Print Name of Nota Publi
KAREN S. NIELSEN
State of Florida Notary Public
_=
Commission # GG 207484
=,;r Q;r My Commission Expires
EOF FIO �� June'12, 2022
�`
Revised 11/16/2 1
i
SUB -.CONTRACTOR SIGNATURE (Qualifier)
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of
The foregoing instrument was signed before me this day of
1 20, by
who is personally known _or has produced a
as identificai 1 0 ti n.
STAMP
Signature of Notary Public
Print
FP
```IM",KAREN S. NIELSEN
State of Florida -Notary Public
Commission # GG 207484
o11;°PP,� My Commission
n Expires
ne