HomeMy WebLinkAboutSub-Contractor Agreement PERMIT#
ac�o ISSUE DATE�' -_.p3�q
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division RECEIVED
BUILDING PERMIT APR ® 6 2021
SUB-CONTRACTOR AGREEMENT Permitting Dapartment
St. Lucie_,cuntti
VV(1 In VOL e— have agreed to be
(Company Name/Individual Name)
the C_ Co y Sub-contractor for
(Type of Trade) (Primary Contractor)
For the project located at r-�- — pL-)Y* S-�- � ue I-. (
(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. r
45U6_CONTRACTO IGN T (Qualifier) ' l CON) CTOI(SIGN (Qualifier)
o A 110o I rr -e s zC-,K
NTNAMEJ 0PRINT NAME
Q kc gt�_7aco &i ld�Y
COUNTY CERTIFICATION NUMBER COU Y ERTIFICATI N NUMBER
State of Florida,County of State of Florida,County of ��1 t
The foregoing instrument was signed before me this J5 day of The foregoing instrument was signed b fore me this day of
!y► a Rol .2021,by T,�-,, ,.w ��Leas'yak ,z��by
who is personally known v-*"or has produced a who is personally known or has produced a
as i tification. as identificatio
STAMP STAMP
Sig, a re of Notary Pub is Signa re f No ary Public
Print Name of Notary Public Q Print Name of Notary Public
�tippV PV�� KAREN S. NIELSEN
: � ``'•'�'�y; JENNIE KNIGHT `---State of Florida Notary Public
Commission # GG 207484
y. '= MY COMMISSION#GG135511 ',;�FOFF�o�°c h9y Commission Expires
EXPIRES August 17,2021 June 12, 2022
Revised 11/16/2(16