HomeMy WebLinkAboutSubcontractor Agreement %, -n OCT 19 2017
PERMIT# — ISSUE DATE
. L 'y' '�.-: PLANNING&DEVELOPMENT SERVICES
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Belding&6d -Col plaaace DWisaon
Tye xY: lB'i7"ING PERMIT j
SUB-COIF t LA.CTOR AGREE K* ENT
c- have agreed to be
(Co parry Name/individual Name) /�
the l�'��t,z� / Sub-contractor for W=y,i A •� Ue U� f s'>�^ P.�•%�'a�/f
(Type of Trade) r� (Pnm�ary`• 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 wHl be,advised pursuant to the
filing of a Change of Sub-contractor notice.
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CONTRACTOR SIGNATURE(Qualifier) ON RACI'ORSIGNATURE•(Qualifier)
PRINT NAME �— PRINT NAME
COUNTY CERTIFICATIONNUM BER COUNTY CERTIFICATION NUMBER
State of Florlda,County of Lutii4-1 State of Florida,County of %-L
�cThe foregoing instrument was signed before me this 1 day of .:.� The foregoing instrument was siggned�before me this`�',�1day of.
2� 1,by `�v\l '� e i �A �1`�'-Q. � �� ;2f��by 1`UIVJ�
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who is personally[mown-Lor has produced a .,s. ;,., who is personally kngwn�or has produced a
as identification. as identification.
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STAMP STAMP
Signature of Notary Public Signature of Notary public
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Print Name ofNotary Public Print Name of Notary Public
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Cqlftf ort. Central •of St, 'Lucie -County, IAA have agreed'to'be
'(Company N'=e&dividfid mme)The HVAC Sub-Ccoit�ctbrfor W :alt De-ve.lox iment Cor .
cry a of wade) (Primary Cax►ttaator)
For the project Ideated at -
'(Project Street A;dil=or It o4 rty Tax MO)
It is u'nderstbdd:that,if there is any change-of status,regarding our puticipaldori with the above mentioned..
-project,-the Builft'and Code Re0atxoh Division of St.Lucie County will be advised pilrsulmtto the
flung of Change of'SUb-oontraotornotice.
CO1V'TIRACTOR MxGNA'TITRE(0-hower). GO IGNAIAT'UIt;E Mu Ncr)
laX=t;haw Lyle Wxhne
PRINT NAAM PRINT NAME
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COUNTYVERTMCATIONMWEA COUNTY CRRTINCAT;ON N[JbMR
State oflrtoridla,Goumty of SST, a F State ofMarlda.County of ST- c- ,F
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V�<�\ 2&_1 by 4"\Q�c SW:, ��All ..1�n� l�]���.2&2 byY SU imwweQNAQXl\ .
who is person8lly.known✓r imuproaacea a • who is pdFSOhaI1y lmuwn °�r rias pYodt�ceda
as fiiehtiticatiom as identiftratioa.
STAW
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