HomeMy WebLinkAboutsub agreement,COUNTY
F L 0 R i v A
the
(Type of Trade
For the project located at
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to be
Sub -contractor for .... elftvd �:o
(Primary Contractor)
q§ q S 33 vd �tr Cif I -
(Project Street Address or Property Tax ID 4)
d, n
Ll Name)
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.
\V
CONTRACTOR SIGNATURE (Qualifier)
PRINT NAME
COUNTY CERTIFICATION NUMBER.
State of Florida, County of—SLI UC 16
Th regoing i trament -was sag i
RO beforeit, 27 Of
520 V by_VJ C 011/6—H
who is personally known 7)(.r has produced a
asidenkification.
STAMP
Name of Nota
KkTj*R1NE HAVENS
M COMI&SGION #GQ1650'30
EXPIRES: DEC 04,2021
7
e 111swance Hondesl thyOugh lst!�Jat
Revised 11/16/2016
Cy
SUB -CONTRACTOR Siil1�ATURE {Qualifier)—
�
_7:�X'/)% a q
c
VKIAI NAME
0'-�
COUNTY CERTIFICATION NUMBER
State of Florida, County oft .'--", LC S
The f regoing instrument was signed before we this day of
CLA_ 20"_)(1 by
who is personally known has produced a
as identification.
1rotary PubW State of Florida
YeNWAyeta
#Ay Co7rtt1bMW HN 076470
0W expimoll=2025
STAMP