HomeMy WebLinkAboutkosloski Sub Contr AgreeCOUNTY
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PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUS -CONTRACTOR ACREEM ENT
have agreed to be
C"N'
mpany Name/individual Name)
the Sub -contractor for
(Type of Trade) (Primary Contractor)
For the project located at
(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.
11
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CONTRACTOR SI6NAT RL (Qualifier)
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of
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The foregoing instrument was signed before me this _ day of
20
who is personal!y.kupwn or has produced a
—a� identiticati f.
Signature of Notary Pubh
d_ LJ tl�§i
Print Name of Notary Public
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�F KLC� [:.Xr�i13E5 # �G143.36
/ September 17, 20
Rei iced l l r 1612i17B 2 Z
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SUB-CONTRACTCiitSIGNATURE (Qualifier)
9
PRINT NAME
COUNTY CERTIFICATION NUIViBER
State of Florida, County of
The foregoing instrument was signed before me this day of
� ,�P�LLB°X-\ 2Q , by ,y,: -
who is personally knownor has produced a
_,.,a�s identircako4.
STAMP Y?�..1
jg5 naturof Notary P.uhlie -
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Print Name of Notary Public
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STAMP