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PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
V /C16, (/"C? v0, P'✓6 9r
have agreed to be
(Company Name/Individual Name)
the tl e-G Sub -contractor for
(Type of Trade) (Primarf Contractor)
For the project located at &i % 9 9 o S 0 C C 4 n --H gc) 'T eta ss i,-, '6'ea c h
(Project Street Address or Property Tax ID #) F ( 3'y i S- 7
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 SIGNATy�U�R�/E (Qualifier)
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PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of
The foregoing instrument was signed before me this oday of
20..qL-,kby
who is personally known _or has produced a
as identification.
?A it, STAMP
Signatur of aryli+ee
�I I n%� Vr
PrintNameo �EN VAUGHN
����V�pV Publi
=o�Pn aState of Flonda Notary
:, *_ Commission # GG 2700e 9
3�. My GCimtitiis n a7P
Revised 11/16/2016
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SUB -CONTRACTOR SIGNATURE (Qualifier)
PRINT NAME
/v 6—
COUNTY CERTIFICATION NUMBER
State of Florida, County of '5�_f -t i'`!
The foregoing instrument was signed before me this�day of
J
by V
who is personally known _or has produced a -tp
as identification.
Signature of Notary
ne of T6ktkt Nffii`�""' ' �pubIi
State of Florida- otary
Commission # GG 270079
My Commission Expires
october 22, 2022
STAMP