HomeMy WebLinkAboutSUBSPERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to be
(Company Nanie/Indivldual Narlpe) r t
the U t�� / -✓✓ Sub -contractor for 90 p 15 6 \ '( C',' r'
(Type of Trade) (Primary Contra tor)
For the project located at ("(UD T NW U IK1 1 U ` ►
(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.
CONTRACTOR SI4Q ATURE (Qualifier)
PRINT NAME ii
t��S� 1
COUNTY CERTIFICATION NUMBER
State of Florida, County of , U)C-i L
The foregoing instrument was signedbeforeme this day of
)W� , 20G 1 by 1 [ 1 )t X0
who is personally known)(_or has produced produced a--
as id tifi�a
fC STAMP
Signatu)-`of Notary Public
L'" f Il - � h--) 6y�'
Print Name of Notary Public
�.r►+'t� Notary Public State of Florida
Christine A. Marsh
< My Commission HH 026766
+� Expires 08/02/2 224
Revised 11/1 016°j�
SUB -CONTRACT SIGNAT (Qualifier)
ri `
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of
The foregoing instrument was signed before me this { Aday of
2( A by l r k��`�_
who is personally knownor a
'D
as ide rf ation�J--
/1 .7 /t STAMP
Signature of Notary Public
cm n'(
Print Name of Notary Public
a
llotary Public State of Flonda
Christine A. Marsh
AA
My Commission HH 026766
Expires 08/02/2024
PERMIT #
ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance D -,— , , u
C e e 7-e
(Company N me/Individ
the C_ I'':0 tQ h
(Type of Tra e)
For the project loc ted at �(
It is understood th
project, the Buildi
filing of a Change
State of Florida, County
The foregoing instrument
3 b.A, _,a
who is personally known
as identification.
Signature of Notary Publi,
C
Print Name of Notary Pub
Revised 1111612016
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
�oLer7` 10a
have agreed to be
Sub -contractor for t000)_�'
(Primary Con actor)
Street Address or Property Tax ID
if there is any change of status regarding our participation with the above mentioned
and Code Regulation Division of St. Lucie County will be advised pursuant to the
Sub -contractor notice.
vas signed before me this day of
�or has produced a
J
i
SUB-CON R P;NATURE (Qualifier)
ROL .,-r A,y li k
PRINT NAME
/ 9 e y�r
COUNTY CERTIFICATION NUMBER
State of Florida, County of :!, 5fi A _ r\
The foregoing instrument was signed before me this — day of
who is personally known 1�1or has produced a
as identification.
STAMP
5tgnature of Notary Public7 i STAMP
l
Print Name of Notary Publte
y `ypY Np Notary Public State of Florida
�° fl'10 A Thomasina Bowins
u r My Commission GG 201733
? ` Expires 03/29/2022
.r9"'r✓af
State of Floridas.Aa
NEIE
BowinsMn
GG 201733rvE12
022'.�
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