HomeMy WebLinkAboutSubcontractor Agreement R E C E I DO 200 2017 .
PERMIT# ISSUE DACE
p .. u:Ku. PLANNING& DEVELOPMENT SERVICES
Building &C®de Compliance Division
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
! (f c �f, c- X_✓7 e— have agreed to be
pany Nameftdividual Name)
the (Coe le c,r r,-z e. / Sub-contractor for W-i,i n t
(Type of Trade) (Primary`.Contractor)
c `
For the project located at :--, \a �ZN
(Project Street Address or Property Talc 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 SIGNATURE(Qualifier) F&JA&COWRACTOR SIGNATURE(Quafier)
PRINT NAME PRINT NAME
COUNTY CERTIFICATIONNUMBER COUNTY CERTIFICATION NUMBER
State of Florida,County of �V( State of Florida,County of�i •."c i'e.
\` \�The foregoing instrument was signed before me this _` day of ;:.;� The foregoing instrument was signed before me this day of
20��by 20\ byVJ�e ICQ �
who is personally!mown Y—or has produced a who is personally knowu_V_or has produced a
as identification as identification.
u � -
,�( STAMP STAMP
Signature of Notary Public Signature of Notary Public
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Print Name of Notary Public Print Name of Notary Public
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PERMIT* ISSUEDATE
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CQm,fort. Qo.iitro1 -of St. Lucie -County, Inc.. haveagreed'to'be
(Compbay Nsmelindividtw Nai nte)
the HVAC Snub-cbnMAotor-For Wvwie Develo.�m-erit Cora.
(Type OfTt;xcme) (Iytsa�aiy Coltttsctor)
For the project Ideated at
(Fioject SOW A:ddress'or l" operty Tax ID s)
Yt is understodd.that,if there is any change-of status.regarding-our paifimpation with the al ove mentioned•.
-project;the Building grid Code RegW4on Division of St.Lucie County Will be advised pugs a to the
fling ot'a Change o£ b-coiitctor notice.
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UO—N t'RACIOR SIMATURE(Quamer)• GD :' IGATA�'[TItE(Qualifier)
M:atthew Lil.e Wznne S.a.z erman
PRMT NAW I►RtIVT NAM ;
COUNTY CERTMCATION NUMM- COUN P`SP•CERTIFICATION NONTl3ER �—
vate orFloTida,county of Si, c,er State of Florida:County of s eci
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The fortgoi thi& day of The fortiabg indralmnt was slvned before me this` day of
26 b3' �
who is personally.keowA✓r hag prbihtced a who is peFsoualtg lmown W"r has produlcea.8
as f5et<tiGostson as identification.
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