HomeMy WebLinkAboutSub Contractor agreementPERMIT # I I i Q� I ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
�1-)SSec 'Ice i ! i have agreed to be
(Company Name/Individual Name)
the l e d f 1, �� Sub -contractor for � � �.
(Type of Trade) (Primary Co actor)
For the project located at
(Project Street Address or*roperty 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 f b- ontractor notice.
LO'
RACT R . IGN.ATE (Oualifier) SUB -CONTRACTOR SIGNATURE (Qualifier)
V " T -5 if
PRINT NAME
S S�1
COUNTY CERTIFICATION NUMBER
State of Florida, County of MMlYN
The foregoing instrument was signed beforemethis day of
20%A, by tJ %r$1\ , OLI S 1/ 1
who is personally known JJor has produced a
as identification.
STAMP
tgna re of Notary Public
CWlffi_&d) n
Print Name of Notary Public
CHRISTINA
Notary Public -St
�.�.
commission ltD937464
Rc%-ised I 1 16/2016 Po `oE
My Comm. Expireded
through Nation
PRINT NAME
C)ap1 ?
COUNTY CERTIFICATION NUMBER
State of Florida, County of (khe
The foregoing instrument was signed before me this da} of
I.�'� a�'iii�•i�
who is personally known V—or has produced a
as identification.
STAMP
Signature of Notary Public
Ph it Name of Notary Public
ALISONHANSON
MY COMMISSION # GG 970043
'• Pa',.= EXPIRES: March 16.2024
Bonded Thru Notary Public Underwritem
PERMIT # 21 D5 �� ISSUE DATE
IRM
COUNTY
FT
A
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
1 QVIUM lb have agreed to be
�ojipany Name/Individual Name)
the Sub -contractor for
(Type of Trade) (Primary Co act
For the project located at % W - 1 —
(P ject Street Ad ss or roperty 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.
CONT O IGNATURE (Qualifier) C SI ATURE (Qu fier
PRINT NAME
COUNTY CERTITICATION NUMBER
COUNTVICERTIFICATIOM NUMBED,
State of Florida, County of
State of Florida, County ofL\
_Y\
The foregoing instrument was signed before me thi
pR'aq••• '
of •••
The foregoing instrument was signed before me this day
2" by
Z
s ^ a
20� by
who is perso wn y kno/) or has produced a
? 3
who is pe Ily knowny—or has produced a
as id 5cation.
o ; )>
as identification.
If Aa
On a -n
0
V n w
�
Signature of Notary Public
Si a e of Notary Public
N n
I
Print Name of Notary Public
Print Name of Notary Public
��yiv'oU •.. CHRISTINA FORTIN
` Notary Public State o' Florida sv'P� CHRISTINA FORTin
o Commission # GG 937464 r�� Notary Fubilt -Mate F,oriea
oF�if`` My Comm. Expires Dec 5, 2023 q; Commisstofl f GG 9's7464
Revised I 16/201�onded through National Notary Assn. -'.'Fp�e,_ My Comm. Expires Dec 5. 2023
Bonded through Naticn� tares yAssr
STAMP