HomeMy WebLinkAboutSubcontractor Agreement PERMIT# ISSUE DATE
r PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
4'zz /� �� s0� have agreed to be
6"- (CAmpanyName/Individual ame)
the C Sub-contractor for
(Type of Trade) (Primary Contractor)
For the project located at 7 9,-�Q 9" e lih--lac/c 0 /
(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 Re ation Division of St. Lucie County will be advised pursuant to the
filing of a C e o -contractor otice.
CONTRACTOR SIGNATURE(Qualifier) S -COOJNTRACTOR SIGNATURE(Qualifier)
PYINT N ME PR �f NAME
C-OUINTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER
State of Florida,County of jfG State of Florida,County of
The foreg ing instrument was signed before me thi day of The foregoing instrument was signed before me thiss'_l ay of
,20l7 by -P` 1 A GVUA-, ,20� V,by WQ .-� � L=11 b-%1 I
who is personally known&has produced a who is personally known or has produced a
as identification. s' entification.
STAMP STAMP .
Signature f Notary Public Signature of Notary Public
` 1111111111111���//i
f�1'Il? i?�f9 7j P�1(S� �seR LAT: ��%
Print Name o Notary Pu Print Name of Notary Public \�� Ssi 3
MARY ANN MAT = � J� ?���`���
MY COMMISSION t/F �313
F95313g GG 051614
W;-'1398�0.63 EXPIRES Januar - _
F Y 2 t.202U �2: :
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Revised 11/16/2016 ii 'QJ_ -..ain ins..