HomeMy WebLinkAboutsub contractorPERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
COP&(es t � s c9 w A+2=1- have agreed to be
(Company Name/Individual Name)
the P(-Cf X/k 0 cfz— Sub -contractor for
(Type of Trade) (Primary Contractor)
For the project located at 6 W ? /(f f Fw a ft:1- A,
(Project Street Address or P erty Tax Ilb#)
(+-t7C- R'1rV So tv LS
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.
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ONTRACTOR SIGNATURE (Qualifier)
G64�12Ce; s +✓ � S'C�l�w ��
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of�,
The foregoing instrument was signed before me this 3A day of
20 2,_, by
who is personally known _or has produced a
identification.
STAMP
ign tore of Notary Pub i
N
Print Name of Notary PublibJ
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=g. , D necemeer�, 2022
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Revised 11/16/2016
SUB -CONTRACTOR SIGNATURE (Qualifier)
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of
The foregoing instrument was signed before me this day of
, 20_, by
who is personally known _or has produced a
as identification.
STAMP
Signature of Notary Public
Print Name of Notary Public