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PERMIT # ISSUE DATE
(Type of Trade)
For the project located at
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
'kkhJ:2— have agreed to be
tl Name) VI,
Sub -contractor for-6,
•� (Primary Contractor)
(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.
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CONTRACTOR SIGNATURE (Qualifier)
CCn i17 /'� /e
PRINT NAME
1 J-1f7C/ C GCG/3 6 G4�G
COUNTY CERTIFICATION NUMBER
State of Florida, County off_ The foregoing instrument was signed before me thisl{1
g4day of
who is personally known or has produced a
Ctification.
STAMP
tgnature of Notary Public
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Print Name of Notary Public
N
�c' s MGG 13M
�+j,�• %
'd1W Uads
Revised It 16 2016
CFC I ;t)35
COUNTY CERTIFICATION NUMBER
State of Florida, County of -UAf 1 ij lax -
The foregoing Instrument was signed before me this JZ day of
20!A, by 1 ICZIoawd l,(,I.JI.Lq iQ.
who is personally known �r has produced a
as identification.
Si re of tary Public
S_LIOLn 0!.r- �'o
Print Name of Notary Public
SUZ NE COU M
(28onftiftowstswimurme
MY COMtiW581 A #=89441
t7O� B: FEB24, 2023
STAMP