HomeMy WebLinkAboutSubcontractor Agreement PERMIT# ISSUE DATE
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= - Building & CoRF
dy Conipkanc'e Division , r
SIUILDI�LVC�PER1GFfT _,< APR 1 1 201f
CT SUB-CUMvEAUI�AGREEMENT
PERF1I 'TING
St. Lucie County, ;_
(1 M Q` have agreed to be:
(Company Name/Individual Name).
the � Arw w Sub-contractor for Aa 1.1"e- yaZA-11
(Type of Trade) (Ptliary Contractor)
For the project located at Li'0_Z-'GD Z'0 t')LA 1Ooa —1
(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. -
Co Cg�TOR SIGNATURE(Qualifier) SUB-CONTRACTOR SIGNATURE(Qualifier)
PRINT NAME PRINT NAME j
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER
State of Florida,County of a")i State of Florida,County of Mal 1
��TAhe foregoing instrument was signed before me this day of The foregoing instrument was signed before me this day of
y Y V ,C,V_ ,20 11,by L �Y zcn l 1\-_)ooSOy\ ,20 7,by- C.,
who is personally known L or has produced a who is personally known 0��r has produced a
as identification. as identification.
•.�:Py•, CHANTAL MONTG MERY
�•� � ;, mmission#FF 487'
us�eaa�es7ots , _ CHANTAtr TGOMER Y
ignature o Notary Public Commission#FF 924875
(( e. Expires October 6,2019
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I V l �G ,R , a'.°°`• B dad Th.Troy Fan Inwnnw f00JB5701E
'Print Name of Notary Public Print Name of Notary Public
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Revised 11/16/2016
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PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division'
fl o
BUILDING PERMIT APR 11 2'01
SUB-CONTRACTOR AGREEMENT
PERMITTIN
St. Lucie C;oun%%
have agreed to be
(Corn any Name/Individual Name) �
the NC6�l CA Sub-contractor for
(Type of Trade) (Prim�ntractor)
For the project located at �GQ2, - UO2 - Q l 0,00 -
(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_Aa&V'J_)A1611-1.
CONTRACTOR SIGNATURE(Qualifier) SUB-CONTRACTOR SIGNATURE(Qualifier)
L �*b
PRINT NAME PRINT NAME
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER
State of Florida,County of (n State of Florida,County of_p y V wC 1 v
The foregoing instrument was signed before me this day of The foregoing instrument was signed before me this day of
zoo,by 2011,by L0(A 19S�Qn-
who is personally known Lor has produced a who is personally known�Xor has produced a
I
as identification. as identification.
( A rA n42��c STAMP �� STAMP
Sign tore of Notary Public Signature of Notary Public
V7110-n c '��
'Print Name of Notary Public H NTAL MONTGOMERY Print m ae of Notary Public
}'""t4�, CNANTAL MONTGOMERY
_ mission#FF 924875 *'Yet
October 6,2019 �. Ccmmission#FF 924875
Q' Expires soo sBsao�s ;.. }
Bp�dThruTroyFeAinsuranw y6 rec Expires OCt0b8f'6,2019
••,�,;,;�• Bonded Thnr Troy Faiv Insurance 800.3057019
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Revised 11/16/2016
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