HomeMy WebLinkAboutSub-Contractor AgreementPERMIT # 2j)OL • O ISSUE DATE
For the project located at
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
(Project Street Address or P operty Tax ID #)
have agreed to be
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.
ONTRACTOR SIGNATURE (Qualifier)
_ P
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of, —
The foregoing instrument was signed before me this S day of
` 20.�, by ��-,��
who is personally known _or has produced a 'FI_ IslJtrbR
a 'dentificadon.
STAMP
Vignature of Notary Publi
Print Name of Notary Public
IASFWHNAINGRAM-RAMMING
W COMt►tISSION # GG 275060
�R p EXPIRES December 20, 2022
••• ilea PubicUnderWors
Revised 11/16/2016
ONT SIGNATURE (Qualifier)
1
PRWT RAMIk'UY,
COUNTY CERTIFI kTION NUMBER
State of Florida, County of ) I t /
The oregoing instrument was A before me this t 9Q.0f
a
2 by
who is personally known has pro ed a
itary Public
1 u�
-, Stu • , . , . , -
Notary Public State of Florida
Jacqueline DeGrandis
Z
My Commisson HN 007272
Expires
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
RECEIVED
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT MAR 2 2 2021
Permitting Department
St. Lucie County
Q l (, �J(-K5 ub - have agreed to be
(Company Name/Individual Name)
the P \ Q (49 (4\ ( Sub -contractor for
(Type of Trade) (Primary Contractor)
For the project located at ('qob
(Project Street AdcWess 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 Change of Sub-c ntractor notice.
06V
I
)A_ t
;�6�c )) k4l 4kp
PRINT NAME
COUNTY C l fteFICATI I &NUMBER We'r
State of Florida, County of _6LLU_C t
The forego instrument was signed before me this QQ day of
by
who is personally known or has produced a i E t ( ,
as identification.
-0,4A AMP
L�L
Signature of Notary Public
Print Name of Notary Public ,,Y�,,KAREN S. NIELSEN
State of Florida Notary Public
_. Commission # GG 207484
My Commission Expires
June 12, 2022
Revised 11/16/2016
ONTRACTOR SIGNATURE( (Q er)
mW5
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of &d (-"
The foregoing instrument was signed before me this _day of
20
who is personally known. 1_0_1rhas produced a
aant�ion,
STAMP
Signature o otary' Public
1ij r !/iJQ
Print Name of Notary Public
PHILLIP LEE BUSMAN
_.• .-_ Commission # GG 064064
;`.. ExpiresApril7,2021
R �L�"• Bmded Tfw Troy Fain lnswance 0
406.7010