HomeMy WebLinkAboutSub-Contractor Agreement PERMIT# �` O \T� ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
i RECEIVED
� k
v BUILDING PERMIT MAY 2 4.1011
SUB-CONTRACTOR AGREEMENT
Permitting Department
St. Lucie County
Custom Air Systems Inc. have agreed to be
(Company Name/Individual Name)
the Mechanical Sub-contractor for MT Construction
(Type of Trade) (Primary Contractor)
For the project located at 6609 US Hwy 1, Fort Pierce 34946
(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.
CONTRAC OR SIGNAT (Qualifier) SUB-CON CTOR SIGNATURE(Qualifier)
0LV& \__�11��r() Curtis Sammons
PRINT NAME PRINT NAME
1321�0 0?774
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER
State of Florida,Countyof Indian River
'/ State of Florida,County of
The foregoing instrument was signed before me this�`7 day of The foregoing instrument was signed before me this 21 day of
20�by fi)01r 44,�f.�ts�ovvi May 202�,by Curtis Sammons
who is personally known or has produced a Dl'C lJC—K� L -La e-Z- who is personally known or has produced a N/A
as iideen,ttiificattion. as
identification.
,/,/15/ /�vl.�.✓!il STAMP _/�/ _r/L STAMP
Signature f Notary Public Signaturelof Notary Public ChVS
R(.
A:Poe`o CHRISTINE B.ENGUSH * * iE1•ENGLISH
* * Commisslon HH 06g32T Aires Hy
Print Name of Notary Public r�oPFLop��� AID614,Z025 Print Name of Notary Public of Flo eJ4�
e++dDeltlo�Y�vtoBs ��
Revised 11/16/2016