HomeMy WebLinkAboutSub Contractor Agreement PERMIT#. ISSUE DATE
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PLANNING-& DEVELOPMENT SERVICES
Building & Code Compliance Division
RECEIVED
BUILDING PERMIT AUG 0 4 2021
SUB-CONTRACTOR AGREEMENT
St.Lucie County
Permitting
Oct/0 —��p ��l ' C0 have agreed to be
(Co pany Name/Individual Name)
the z5/P ce, Sub-contractor for k-C rC Pe-A PH
(Type of Trade) (Primary Contractor)
For the project located at 7 3O LIS I kwG 1
(Project Street Address or Prope Tax 10#)
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.
01 CONTRACTOR SIGNATUR (Qualifier) 1~ SUB-C TRACTOR SIGNAT Qualifier)
PRINT NAME
PRINT NAME
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBEIP
State of Florida,County of 101 &a-41 State of Florida,County o
The foregoing instrument was signed before me this Y day of The foregoing instrument was signed before me this day of
AU4202-1 b±has
v�+`�Q 1(dofYyf•� ,202,by .
who is personally known orduced a who is personally known or has produced .G
as identification. as identification.
STAMP STAMP
Signature of Nota•y u Signature of Notary dP%
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Print Name of Notary Pu lie
m Print N of Notary Public r
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AUDREYB.HUMPHREY
• MAYRAAWRCIAMY COMMISSION#GG 300817
Notary Public.State of FloridaEXPIRES:March 6,2023
o= Commission of HH 054187Revised 11/16/2016 a d�' My Comm.Expires Oct 15,2024 °•' Bonded ThruNoWdy Public Undenvriters
Bonded through National Notary Assn. =—