HomeMy WebLinkAboutForbes Remodeling - 5513 Spanish River Rd - SLCPERMIT # - 6-1 2j _• ISSUE [?ATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
(Company Name/individual Nam)
the ` + NVfi-('_ Sub -contractor for
(Type of Trade) I
have agreed to be FDN'1- Q Y �Q Y0 CDf)4((X"4
(Primary Contractor) J L•LG
For the project located at Q t:) I d JOHK k 61Ye- V
(Project Street Address or Property Tax ID #)
It is understood that, if there is any change of status regarding our participation with the above
project, the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the
filing of a Change of S -co tractor notice.
CONTRACTOR SIGNATURE (Qualifier)
PRINT NAME
,3�-77
COUNTY CERTIFICATION NI MBER
State of Florida, County ofrt..
The foregoing instrument was signed efore thi £
�� rllp�w
2g7Pby
who is personally known _or has produced a L-
as identification.
STAMP
Signs ure of Notary Public
de_G 4
p1ot8YY
P%�-state of F}pri
issipn # CC' 207454
Tan ExQires
v oe� n,M1v La'n �'1
2. 262�
J�sn
Print Name
ICAR�� S. NIEI-S Public
-00-CDkfIACTOR SIGNATURE (Qualifier)
Q-
5 3A
PRINT NAME
4- Atoy i q
COUNTY CERTIFICATION NUMBER
State of Florida, County
The foregoing instrument was signed before me this -aavl of
20A by���
T.ispersl...Iyk.own ✓ or has produced a
as identification.
T N� �RIIVA+(f V11
Signature of Notary Public��—+'Gp�buAy�A
SABRINA L. BLACK
Apr
Print Name of Notary Public #GG,2'
7A
pie A� •. '7� iJ�d�S'N, • Q¢ `�\