HomeMy WebLinkAboutSubcontractor Agreement PERMIT# /,� ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
iCOLINTY
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
L•Ji"! have agreed to be
(Company Name/Individual Name)
the GG Sub-contractor for Geagn ate
(Type of Trade) (Primary Con actor)
For the project located at ��/� / � - �l
(Project Street Address or Prop rty 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.
CO RACTOR SIGNATURE alifier) SU CONTRACTOR IGNATURE(Qualifier)
eve) 0 ini"92f .'r-"
PRINT NAME PRINT NAME
3 73
COUNTY CERTIFICATION E • COUNTY CERTIFICATION NUMBER
State of Florida,County of f .0 fop State of Florida,County of� L JCS k
Oforegoing instrument was signed before me this day of The foregoing instrument was signed before`me this day of
20�by .�l��V 20� by {CA Wes►t sR /rA�}�
who is pe pally known_or has produced a who is personally known_or has produced a L
as i nti' tion. as identification.
STAMP STAMP
a e of Nota lic Signature of Notary40ublic
Print ame of No ry Public Print Name of Notary Public
����� :�*pv'6�8.•, DEANNA GIVENS
. Notary Public State of Florida :� ��= Notary Public State of Florida
Alice L.Simpson o`s Commission a:HH 086359
• My Corttnission HH 031860 ''®A M Comm.Expires Jan 28.2025
Revised 11/16/2016 p w Expires 08H3/20yq "°F Y
Bonded through National Notary Assn.