HomeMy WebLinkAboutSubcontractor Agreement PERMIT# /1
1
0/ 0142J1 ISSUE DATE
PLANNING & DEVELOPMENT SERVICES'
Building & Code Compliance Division
BUILDING PERMIT � ta�
SUB-CONTRACTOR AGREEMENT
OCT 26 2"
ST. Lucie County, Permitting
have agreed to be
(Company Name/Individual Name)
the (, ( (_y� U l��fi/4L)ub-contractor for A v t L (010 S� , `0-1100 1 Lv,
(Type of Trade) _ (Primary Contractor)
For the project located at 7^`7 2 2- 0 t wc�
(Project Street Address or perty Tdx 0#)
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 SIGNAT (Qualifier) SUB-CONTRACTOR SIGNATURE(Qualifier)P.
PRINT NAME PRINT NAME
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER
State of Florida,County of 1 State of Florida,County of ; j !- ,
The foregoing instrument was signed before me this*day of p The foregoing instrument was signed before me this day of
YJ ,20 by ` -S 73 C� V ,.� ,20U by
who is personally known or has produced a who is personally known_or has produced a
as'dentification. as id ti anon.
pVR Notary Public State of Florida Notary Public State of Florida
Dianelis Rodriguez Dianelis Rodriguez
a My Cgmmission GG 299407 My Com�jypipp GG 299407
d► Expires 02/07/2023 STAMP Expires B7/fA 12�23
S' at of N a Publi Sign re o otary lie
Print Name of Notary Public Print Name of Notary Public
Revised 11/16/2016