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PERMIT# r—
ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
COUNTY
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
i
have agreed to be
(Company Name/Individual Name)
the Ea, zlc- Sub-contractor for
(Type of Trade) (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.
CONTRACTOR SIGNATURE(Qualifier) SUB-CONTRACTOR SIGNATURE(Qualifier)
PRINT NAME PRINT NAME
DDD
COUNTY CERTI A NUMBER COUNTY CERTIFI ION NUMBER
State of Florida,County of Jr� w� State of Florida,County of ,.S+7 (.[
I
The foregoing instrument was signed before me this day of The foregoing instrument was signed before me this�ay of
r 20 rl by ,20?"Uy
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who is personally known or has produced a who is personally known or has produced a
as identi£ Lion. as identification.
STAMP STAMP
Signature of Notary Public Signature of otar ublic
ELLEN VAUGHN
._ State of Florida-Notary Public
....,Name of Not Pub i �� = Commission # GG 270079 Print—Name of
q O
+0I.,,, I-1P11 My Commission Expires �,,����u„ ELLEN VAUGHN
'�"!" October 22, 2022 :o`P"typy�'- State of Florida-Notary Public
Commission # GG 270079
y Q My Cc missionx22res
Revised 11/16/2016