HomeMy WebLinkAboutSubcontractor Agreement R E C E I'Ab SEP 2.0 2017
PERMIT# — ISSUE DATE
.:. PLANNMG& DE�IELOPll�IEN'P'SE'RWLTS
Building &Code Con pfinnee Division
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
r r, c— have agreed to be
(Co pany Name/Individual Name)
the ! Sub-contractor for CAJ-4 r n Ae c t✓ l`i^ ew•'e-c..�
(Type of Trade) (Prima6 Contractor)
For the project located at �-
(Project Street Address or Property Tax ID#)
It is understood that,if there is an change of status regarding our participation with the above mentioned
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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 SIGNATURE(Qualifier) O ` RACTOR SIGNATURE(Qualifier)
PRINT NAME PRINT NAME
COUNTY CERTIFICATION.NUMBER COUNTY CERTIFICATION NUMBER
` State of Florida,County of l..0 State of Florida,County ofs�:A Laxt-1-Z- '
!I The foregoing instrument was signed before me this da of The for
instrument was signed before me tbis�' day of
20�,by �v\� o Ls��� V� �20Qby I�A���1f`CQ � [S J
who is personally!mown Y—or has produced a who is personally known_V_or has produced a
as identification. as identification.
STAMP / STAMP
Signature of Notary Public Siguature of Notary Public
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Print Name of Notary Public Print Name of Notary Public
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CQmforlr Qo.ntro1 -0T St. "Lucie -County, Inc., have agxeed'to'be
(Cofup$it�'Naatallndividua�I��ae) .
the HVA-C Sub=coitftotorfor Wgnne beve.lonimen't Corp.
Crype of Trade) (y� (i�rimaiy'Costramr)
For the project Ideatedat . : V,-k G ���. • .•.
(Project met A 4dms or?zopetty Tax ID*)
It is iinderstb6d:that,if thei re as any ObSBge'Of status ire ding Our pattivipation with the above mentioned.
-project;the Wi ft-a11d Code Regulation Division of St:Lucie County will be advised pilramt.to the �
fling of Change of 80-comet-etor-notice.
CUN'T�ACCQR S!«TATURE(Qtia6ffer)• .'GO ;• .. . IOATA�'URE(Qu�ifiery •,.
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