HomeMy WebLinkAboutSubcontractor Agreement i
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PERMIT# O • O ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
COUNTY
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
I
have agreed to be
( mpany Name/Individual Name)
;the F leOR).it 0-L Sub-contractor for
(Type of Trade) (Primary Contractor)
For the project located at !!l193 �S �l W � ►i�«/ �"��
(Project Street Address o 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.
CONTRACTOR SIGNATURE(Qualifier) -CONTRACTORS RE(Qualifier)
PRINT NAME VRRINT NAME LOP
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER
State of Florida,County of cl�•��.�.Ct State of Florida,County of X_L• C�
The foregoing instrument was signed before me thi i S day of The foregoing instrument was signed before me this s day of
I � tom,
r ,20 u by 1 A" -0"4- 'J W 1•iS� P�!/t Lt&!r ,20Z((,by Aenv w old e
who is personally known oas produced a who is personally known or has produced a r h
I
as id e 'fication. aside 'nation.
yO �
0✓� ^' STAMP /Yt •T�_ STAMP'
ignature of Notary Public re of Notary Public r =
Print Name of Notary Public Name of Notary Public -
gigc State of Florida jW�K Notary Public State of Florida
fflth - Sharon L Griffith
sion GG 107069 �� My commission GG 107069
2f2021cr rd� Expires 05/22i2021
(Revised 11/16/2016