HomeMy WebLinkAboutSub-Contractor AgreementEPERM[Tr# I (� I 0-74 ISSUE DATE 1 LA. Zc�
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT RECETV E b -
SUB -CONTRACTOR AGREEMENT J A N 14 2019
' ST. Lucie County, Permitting
have agreed to be
(Company Nam dividual Name)
Sub -contractor forL�� /
(Type of Trade) UL��
(Prnnary 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 will be advised pursuant to the
filing of a Change of Sub -contractor notice.
i
COUNTY TIFICATI!Mc
CCState of Florida, CountyoftG
I
T foregoing instrument was signedbefore me tbi9 day of
20 _&try '
who is personally known _or has produced a I c
as identificatioo-
I
Signatur of Notary. Public. ST AMP
Print Name of Notary. Ay PUB �K A R E N S. N I E L S E N
;� ,, State of Florida -Notary Public
•E Commission # GG 207484
' r My Commission Expires
�7�uni�o`�� JUne112, 2022
Revised 11/16/2016 1 ,
A �
S Me SIGN
PRINT N
el
COUNTY CERTIF aM . ER
State of Florida, County' of
The foregoing instrument was signed efore me this day of ,
20W by
who is personally known or has produced a Q
as identification.
Si re of Notary Public
KAREN S. NIELSEN
Print Name of Notary Pub :° ;State of Florida -Notary Public
=' Commission # GG 207484
My Commission Expires
June 12, 2022
PERMIT # i �Cr y ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT RECEIVED
SUBTR -CONACTOR AGREEMENT BAN 14 2019
ST. Lucie County, Permitting
ed t b
e Company Name/Individual Name) agreo e
the `mow Sub -contractor for�rL "z
� <
(Type of Trade) Wrkwa f Contractor)
For the project located at �D/ �', (��!��, j' 1
-(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.
I00 P �%
C_ SIGNATURE Qnalifie
� � A
PRINT NAME
COUNTY TIFICATIO
State of Florida, County of--�a�li t�
foregoing instrument was signed efore me this day of
20 Wby
who is personally !mown _or has produced a
as identification.
STAMP
Signatur of Notary Public. i
COUNTY CERTIRCAU . ER
State of Florida, County of
The foregoing instrument was signed efore me this day of
zo7� by
Who is personally known or has.produced a
as identificatioC::� A k___,-,R
Sig&t&e of Notary Public
�nuu,, .
Print Name of Notary. `' •P % KA S. NIELSEN
�TFr'd� KAREN S. NIELSEN Print Name of Notaryl'ub :° ;State of Florida -Notary Public
e<,,- State of Florida Notary Public =* *= Commission # GG 207484
.__
Commission # GG 207484 =; o
My Commission Expires
My Commission Expires
Juneil2, 2022 June 12, 2022
Revised 11/162016
DEVELOPMENT
Compliance Division
have agreed to be
(Con any N effndividual Name)
the T vv i� ��� L.: Sub -contractor for t r
(Type of Trade) UL � �Pr
(Primary 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 will be advised pursuant to the
filing of a Change of Sub -contractor notice.
C OR SIGNATURE 96ime
PRINT NAME
COUNTY T CATTO NUr
State of Florida, Comity of
rwc
T4 foregoing instrument was signed efore me tbi*
7Mday of
04
Zo . , 1
who is personally (mown or has produced a L QL_
as identification.
STAMP
Sigaatur of Notary Pab6c.
i
Name of Notary- �rirr, KAREN S. NIELSEN
�f`PpY PVB
a -State of Florida -Notary Public
---a
Commission # GG 207484
+� °e? My Commission Expires
June 12, 2022
Revised 11/16/2016
tki ney
COUNTY CERTIMATIOM NUTBER
State of Florida, County of G %E',
The, foregoing instrument was signed efore me this day of
who is personalty (mown _ or has produced a CX-,
as identification,
C::� A k__, L
Sig&taie of Notary Public
S, NIELSEN
Print Name of NotaryPubl :° �:State of Florida -Notary Public
•E Commission # GG 207484
My Commission Expires
rrr'r""��` June 12, 2022
the
For the project located at
& DEVELOPMENT SERVICES
& Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Sub -contractor for
have agreed to be
1-11 _ i
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.
I
iIGNATURE Qoalifie �
State of Florida, County of e l
foregoing instrument was signed efore me C
20_Wby
who is personally known _or bus produced a
as identifieatioti, rl I 1
of
Revised 11/16/2016
Pday of
. . -
COUNTY CERTIFICATI ER .
State of Florida, County of G tE
The foregoing instrument was signed efore me this Lq— day of
Zo?�
who is personally (mown or has produced a
as identification.
S' a of Notary Public
l
.a"'r'd''�, KA S. NIELSEN
;�,YP;a,KAREN S. NIELSEN Print Name of Notary Pub S;:, ;State of Florida -Notary Public
��-State of Florida Notary Public =* Commission # GG 207484
Commission # GG 207484 ';, Qe�
9 �.�` My Commission Expires
f f�R My Commission Expires p
'mu��`` June 12, 202Y June 12, 2022