HomeMy WebLinkAboutSubcontractor Agreement PERMIT# U _ �V 2 / ISSUE DATE
v PLANNING & DEVELOPMENT SERVICES
'Mffili `��t ' `° Building & Code Compliance Division
RECEIVED
--- - BUILDING PERMIT SUB-CONTRACTOR AGREEMENT OCT 18 2017
PERMITTING
St. Lucie County,FL
et- &J F iL/S D14 ) dj 2 have agreed to be
(Company Name/Individual Name)
the ACC Tie rC 4 L— Sub-contractor for
(Type of Trade) (Primary Contractor)
For the project located at l 10 2 Q C-- &,
(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-cont ctor notice.
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CONTRACTO S GNATURE(Qualifier) SUB-CONTRA R SIGNATURE(Qualifier)
FCe)�� dv✓rav$
PRINT NAME ,/ PRINT NAME
l -/Ajl'ldvolr
V Ingr
COUNTY CERTIFICA ION NJJMBER COUN IFICATI BER
State of Florida,County of �� State of Florida,County of�E_�lc
The f egoin ustrument was sig ed before m his day of Mr
oi g instrument was sign efore me thi di f
21) ,by r J 20�T
who is personally known_or has prod iced a who is personally known or has produced a
as identificati as identifrcat'
S AMP STAMP
Sign re of Notary Pfiblff Signatu of Notaryi
; KAREN S. NIELSEN
Fl
=.° �'= Commission#FF 115637
=• •= Expires
S. NIELSEN -
PrintNameofNotaryPublie ;� '�? Commission # FF 115637 Print Name of ,a�w.�'ra�� June 12, 2018
�•nopa
My Commission Expires
June 1 2, 2 0 88
Revised I1/16/2016
EEM
# /—7 1/-� v O 3 � ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
RECEIVED
SUB-CONTRACTOR AGREEMENT OCTa 2�7
PERMITTING
/' St. Lucie County, FL
4 t?C `�P O w E u JA) o) J i have agreed to be
(Company Name/Individual Name)
the P/-,L/11 Sub-contractor for
(Type of Trade) (Primary Contractor)
For the project located at f l 0 A, r-L EC-AJd 0_Q 1) . 3 q_2e 2
(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.
CONTRACT GNATURE(Qualifier) SUB- IU, O SIGNATURE(Qualifier)
PRINT NAME PRINT NAME ✓
C I I I agee'_/9 IV, 1CL Y,
Couwff CERTIFICIATI01ITNUMBER
COUNTY ERTIFICAT N BER
State of Florida,County of_UL State of Florida,County of�Ic
Th for g instrument was signed before me this day of The regoi g instrument was by .204bysigne efore me thi day of
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all
who is personally known or has produced a D who is personally known or has produced a oil
as identification. as identifi tion.
1 0 fi A A KL /
STAMP �� STAMP
Signature of Notary ublic Sign ture of Notary Public
I:";.% KAR
SE N ELSEN
Print Name ofN li ,_ Commission#FF 115637 Print Name of Not Commission#FF 115637
My Commission Expi es r 'v , Y
orr. M Commission Expires
June 12, 2018 June 12, 2018
Revised 11/16/2016