HomeMy WebLinkAboutSubcontractor Agreement PERMIT# ISSUE DATE
q_ PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division t , R,
• c �.
BUILDING PERMIT �I
SUB-CONTRACTOR AGREEMENT 14AY n
PCIiF:rlr,.
St. Lucb: .
have agreed to be
(Company�mefi dividual Name)
the ? ruj^�?�� Sub-contractor for
(Type of Trade) (Primary Contractor)
For the project located at 6Y A v, 1Q, br,Ur- -6e c-- i , F1 <(9 S
(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.
� j-
CONT CTOR SIGNATURE(Qualifier) SUB-C NTRACTOR SIGNATURE(Qualifier)
PRINT NAME -
PRINT NAME
COUNTY CERTIFICATION NUMBER COUNTY CERTIFI ATION NUMBER
State of Florida,County of ��j Q State of Florida,County of AluaEl
The
foregoing instrument was signed before me this I day of The foregoing instrument was signed before me this day of 9'
V i} J 20-o,by 20_6,
who is personally known_or has produced a who is personally known_or has produced a
as identification. as identification.
STAMP C STAMP
Signature of Notary Pilllic Signature of No ary Public
- — KAREN S. NIELSEN
Print Name of No ;c, ��LSEN =Q� Commission# FF 115637
�?r Print Name of Notary = My Commission Expires
Cormission ;# FF 115637 Wig' 2018
"•' g`o June 12,
My Commission Expires
June 12, 2018
Revised 1111612016
PER MIT
ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT MAY 0 Q 2017
PEP[*RITTiNG
Q / St. Lucie Counts.
have agreed to be
(Company Name/Individual ame)
the Z-le_C- rj Sub-contractor for &opi 6-y'
(Type of Trade) (Primary Contractor)
For the project located at 6 Y ;��. a �1 v e z'^'�5�� ���-cGt F 1 3 e(S S 7
(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.
CONTRA OR SIGNATURE(Qualifier) SUB-CO RACTOR SIGNATURE(Qualifier)
(2k-5 Dw/`
PRINT NAME PRINT NAME
a"); I ;
COUNTY CERTIFICAJnON NUMER COUNTY CERTIFICAITION ER
State of Florida Countyof
C State of Florida,County of_ .I I
The foregoing instrument was signed before me thist day of The foregoing instrument was signed before me this day of
v .204 by L�r� /�)�1 Pq 10—y' H�— — � 20_0by. i/
who is personally known_or has produced a 1 who is personally(mown_or has produced a
as identifi tion. as identification.
7
STAMP STAMP
Signature of No ry Pnblic .. Signature of Nbrary Public
KkREN S. NIELSEN
tigar o„o any:
Commission 9 FF 115637
Print Name of Notary Pub c k= V ssion Expires e,^ o
�T ac Print Name of Notary �_ ' S,
June 12, 2018 Cum NIELS (\j
mission u FF 115637
MYCommission
Exprrgs
?2, 2018
Revised 1111612016