HomeMy WebLinkAboutJames and Kathleen Dwyer - Sub Permit Application PERMIT# ISSUE:DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
.Q! EEM- -
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
o be
(Company Name1ndividLial Name) _have a;geed t
the E lfe A,:C- r ct n _ Sub-contractor ford{/,: iie,, i� �
(Type of Trade) ( imary Con tor)
For the project located at 0, ��z S5� �`� >�r ✓Z �1irr`f'�� �- fz <3�
(Project Street Address or Property Tax ID r)
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
ram.
filing of a Change of SP-contractor notice.
NTRACTOR SIGNATU (Qualifier) SUB-CONTRACTOR SIGNATURE(Qualifier)
PRIN't NAME PRINT NAME
—5�
COUNTY CERTIFICA' N.' 1IB (?0t-_NT4 CERTIFICATION NUMBER
State of Florida,County o�� 'v L-y mac- rr�'� State of Florida.County of Lam a'C4'
Theft omg instrument was signed before me this�1&da�%of The foregoin.-instrument was signed before me this 3 dayof
/ ( 24.. by !ft _ C1S�!u•-->2021,b}
gIt"ir.
sonally known Y ar has produced a _ who is personally laown�Ir has produced a
1
.wn. as id ntification.
+./�l//b STAMP �_� STAIN&
Signaltine of Notary"Pub' Signature of.Not.k y Public
'V)r/6 flla l_i
Print Name of Notary Pub c Print Name of Notary"Public
BOGGS
Eum
Notary Public Stateof Florida
Sandra A Simmons My commission eG 930W
Expires 0210312024
Revised II'16/2016