HomeMy WebLinkAboutSub-Contractor Agreement$U51A E.
PERMIT'iW IS. AT
'
W
PL -AN M-NG LOPME E, SERVICES
VISIOIi RECEIVED
'D'
Omp
JUN 1*7 2021
BUILDING'r,
kdlikEWNT' St. Lucia County
PermilitInQ
C_
1) C 4 &w ha've',a_-g--'r-eed,tO.'lie
Ud Natne),
b co -trac
lP4mary.,CbntrgctorX
located;rzn)�q_
ft.tAd&e 'T i(Project" Street' wor.ftOper_tY,,.tbHD
_3 -5.....
R is undersibbd-thatff th-eip, I ,eof_StatUS_re.-&dine.,.Our pat4oipatlon_with the.above,,mentibiled
pro 046 Regulation Divisip O-St tithe County. will,b . UaIrk-16-the..
:project Bijilding, afid..'O, .01-44Avised'-PWI-1
filing of:a Change -6f `Sub -on
CONTRACTOR
PWITINAW
COUNTY 'CERTMCAT1O:N,7EP
le't
vi
bya,
wlio ls;personiky, imown,—orfihs;' "Aft h t
.,. pra &d
as iaentidtad6p,
Print JVnmeoFNotaxvPutiTic
KAREN S ' NIELSEN
64,"�sState of Florida -Notary Public
Commission # GG 207484
F F,
M -ssion Exphes
Vz My Corn' i
June.12, 2022
. WP'gNTRACTOkSIGNAT.tu',(Qualifier ,
rMITN"M
C F, 0-,
COIWY C M-TMCA'AON MME.R,
" DjajdtnftL z it
N
KYLIE VERA
Notary Public - State of Florida
Commission - NH 75942
My Comm. Expires Dec 29. 2024
;STAMP:
ISSUE EMWE,
PLANNING & DEViLOPMENT NICES
Building,.& Cade Compliance .Division
,SUB-00NT,RAC,.. TORAGREMM NT-
RECEIVED
JUN 17 2021
St. Lucie County
Permitting
__(_X_1i_\_ CAfte dove agreed to be
(Con dNme)
Vaqy,Namq?T0_qv1du
the Aim
(Type cifTn0e)
For the project lomie&at-
Itis understodd that, if there is any chance of stains Teg with the oiled
gardingOurpatilcipafionwi. ibove�mejfti
ii Division , of St. Lucie county ��111 be advised vursua , �t -Io -the
Project, the Building-andCode.Regulan 0
filing of a Chan.0 of '$ub-cOntr4tor. no,tice.
7 7 Co�
Ce
CoUNTY cERTmCATION LMMBER
State of Florldii, County Of, -
Tteforegoinginstrume
0 ope
%vhois,perso=Uyknoivn—orhupr4dticedo V-.0 w,
'usideAtMca
STAMP
Offmetm"_ P-Ablik i.
S. NIELSEN
Print-Name-ofiXotaryPubi gtate of Florida -Notary Public
n 11 GG 207484
Commission
ion ExPires
My C "Irlis,
June
12, 2022
Revised 3IAW2016'
COUNTY CM- M-IC&TIONNUMBER
State .of1hoAdoxonutkod ✓5 + - I �- GI e
,the foregoing histroiji6t jpas signed before me tbls// -%y of
0L.
Print wam Or Notarypublic
i* I
Cam A. Qub=
VNotary Public*5State of Florida
Comm# HH080
682
EA%%
Expires 1/13/2025
Sqc'�'s
C_
PERMIT#
"( ISS E'nATE
a_ '�'1.
PLUG &. bE-VELOPMENT SERVICES
Building~& Code Compliance Division RECEIVED
NOBUELDING PERMIT J U N 17 2021
SUB -CONTRA dTOR" AGREEM9NT
St. Lucie County
j Permittino
have agreed to be
(Company tQnelIiidividual. Name) L
the Sub=ccintcactor fore, 4ez
(Type of Trade) (Primary Contractor):
For the projectlocated;at�
(Project Street -Address or Property Tax ID #) � . • jp.� �ryQ4��
It is understood that,.if there is any chap a of status regarding our arheipation with the above mentioned
project,,the Building- and=Code Regulation Division.of St. Lucie.Coulity will be advised pursuant to;the
filing :of a ChAnge:of•Sub-contractornotice.
CONT"CTORS ATURE (Qualiffery
v� � GCs�w►
PRINT NA ,tE `
COUNTY CERTIFICATION Nf.T U= nn
State ofFlorida, County of.�V��
The
``foregoing:instrument}tiussignedbeforemet _n'd0of
ivho is personaIIy known `or has produced
asfdentificati
�S�TAA _ �
iSignature of Notary W
404CON SIGNATUBE(Qvaiitfer)
i PRINT NAM
i COUNTY CZ:RTMCATION�N,[J�ilNI�B,ER"
State of Flonda, Couaty`of a i�84-b °
Thefbre9oingjnstramcn�t,+�vassigneii.befcreme thisd��'day of
l (i1A�rC 20 b'
1 � S, t C1C
avhoiis,personallyknown �rdiasproduced:a'
I as'f4entifi .tion:
STAW
Print Name of Notary'Public
KAREN S. NIELSEN
State of Florida Notary Public
__. •= Commission# GG 207484
9 ,?; My Commission Expires
June 12; 2022
Revised 1:1116!2016.
.4 A rib-l® u
RoM1,/;' Notary Public State of Florida.
" o : Maria A Molina
y c : } kly Commission GG 211062
'Ole eon Expires 04/25/2022
j
PERMIT# ISSUE DATE
the
(Type of Trade)
For the project located at
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILD NG PERMIT
SUB -CONTRACTOR AGREEMENT
n
RECEIVED
JUN 17 2021
St, Luoi® County
pamliong
have agreed to be
L,L., C,
or Property Tax ID #) . `7'►C% cb .: CDt`
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 -contract otice.
S to of Florida, County of
S/t. C� E
T e foregoing instrument was §ipW before c d
20 by _
who is personally +vn or has,produced a.
as identiticai r \
day of
Print Name of Notary Public
KAR.EN S. NIELSEN
=e�PPYFLB�:State of Florida Notary Public
_■ *= Commission # GG 207484
.,
My Commission Expires
Jtin,. 12, 2022
Revised 11/16/2016
COUNTY CERTIFICATION NUMBER
State of Florida, County of l
The foregoing ibMrument was signed before me thisday of
. 20,_.1 by
who is personally known or has produced a
as identification.
STAMP
Signature of Notary Public.
Print Name of Notary Public
ST--E
FLORIDA INDIVIDUAL ACKNOWLEDGMENT
...L' %:;r.4:`.�:. ti .� ' Y' -.K.: •.L- ,L-;'J:. :.n,�.. ...i�y�. •.:e •C:,..'•i .tv .`. a;:^'-1�" • ."r+�sY� ' w^�`` 3.5"•. ,}• _ � , ti> _
State of Florida County of hA ot44i V1
ri�Y Pv`•.,.
a
llotary Prida
comm.
MY Comm.023
Place Notary Seal Stamp Above
The foregoing instrument was acknowledged before
me by means of
Physical Presence,
—OR—
❑ Online Notarization,
this `A day of A\)"L- , by
Date Month Year
AM VA
Name of Person Acknowledging
Signature of Notary Public — State of Florida
Mav'\t S P-1
Name of NotaryTyped, Printed or Stamped
❑ Personally known
Produced Identification
Type of Identification Produced: ip1—kts
Completing this information can deter alteration of the document or
fraudulent reattachment of this form to an unintended document.
Description of Attached Document Q
Title or Type of Document: J� �a�lV►. �OV�� ` We,
Document Date: A10 1 �-V�- Number of Pages:
Signer(s) Other Than Named Above: N 'A
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