HomeMy WebLinkAboutPermit 2011-0479 Sub Agreement 117 Queen Eugenia Horton Res_000495PERMIT # I a 4
ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
iP& K C6zAa c -et-e l LD P_:f kg �l l
have agreed to be
(Company Name/Individual Name) L
the &&--ceSub-contractor for 'S t.`J G ecrr.'c_
(Type of Trade) (Primary Contractor)
For the project located at % ao—e'q' Cr
(Project Street Address or Property Tax 1D #)
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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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CONTRACTO SIGNATURE (Qualifier)
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PRINT NAME
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COUNTY CERTIFICATION NUMBER
State of Florida, County of Yy . L.li C-c t
The foregoing instrument was signed before me this t*_ dac of
r; 201L, by i �!
who is personally known or has produced a
as identification. �,Q
tl.l1�-tSC� Q1J(- STAMP
Signature o : 'otary Public
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Print Name of Notary Public
SUB -CONTRACTOR SIGNATURE (Qualifier)
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PRINT NAME
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COUNTYCERTIFICATION N17MBER
State of Florida, County of SC' . - C- t t
The foo�re�goiing� instrument was signed before me this / day of
AQ20f1,by
who is personally known -or has produced a
as identification.
Q.lilAL� i�Ot_t.3�1� STAMP
Signature of N4tan. Public
'�<af-!:�n Ca ' CXr A
Print Name o Notan Public
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