HomeMy WebLinkAboutsubcontractorPERMIT# rL t.� _ bl —7 Z ISSUE DATE
°N PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
s
• s
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
,US�j�U't �lyl�2t+-VL� h ve agreed to be
(i u y Name/Individual Name)
the F (r)'3 1, I,Sub-contractor for �� � • y
(Type of Trade) r(Primaryy Contractor))
5�
For the project located at D 6o0P C-r l5[� �� IVrEr' . ' ' I L � t ' �S
(Project Street Address or Property Tax ID 9)
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
Min- a Change , u - tractor notice.
E0_N-fR.J%tW6R SIGNATURE (Qua i6er))
&Wfz, ! �`
PRINT NAME
COUNTY CERTIFICATION NOMRER
State of Florida, County of& [, &Ou a The foregoing instrument was signed before me thi:- !�%
day of
ITMie 201C, by
who is personally known _or has produced a
as identification. J ��
STA:%IP
signature of m ary Public
Prini .Name of'Notary P
f
SLB-CONTRACTOR SIG ORE( nliGe
Lonny l Mtn
PRINT NAME
a4( 5+ fj�I1Q673-72
COUNTS' CERTIFI ATIOX NUMBER
State of Florida, County of 81 n
'',%t1
The foregoing instrument Nyas signed before me this iW day of
M P"Y 20a, by
who is personally kn wtrV _ ns produced a
asiden' a'
t
STAb1P
Siganture�of y\o�mmPublic
�
Print Name of Notary Public
:u'
Notary Public State of FtofidaRevised 11/16f1016 - - Katl' m, CaldGG My Commission GG 17rO 9677EATHER BURFORD Expires0112B12022
State of Florida -Notary Public
Commission # GG 183217
My Commission Expires
"'� i" Febrdery 06, 2022
L64