HomeMy WebLinkAboutSub-Contractor AgreementPERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
oardlw- Celro(-6
(Company Name/Indi dual Name
'the /v t 1 iC
(Type of Trade)
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
G.
have agreed to be
Sub -contractor for t-/'1 i& 1 V6KWI a-(q
(Primary Contractor)
For the project located at &),95 / ! n J-h� Dr,
(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 Regulation Division of St. Lucie County will be advised pursuant to the
filing of a Change of Sub -contractor notice.
C NTRACTOR SIGNATURE (Qualifier)
AnAm ®rm(W
PRINT NAME
W b A.
COUNTY CERTIFICATION NUMBER
State of Florida, County of S4 • ) t& C 1
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The foregoing instrument was signed before me this Xday of ,,••
20�by_AN i
is personally known or has produced N �,
as identificati n.
TA
Signature of Notary Public
SUB-
CONTRACTOR SIGNATURE (Qualifier)
4f--Man
PRINT NAME
ilk,'
COUJrY CERTIFICATION NUMBER
State of Florida, County of � itC, / C—
Th oregoing instrument was signed before me thisXday of7p �y� !'
n 20A)byn � 1n`?1,I
Uhs personally known _or has produced a C .
as identific tion.
Signature of Notary Public W
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Print Name of Notary Public J Print Name of Notary Public
Y B. HUMPHREY -•`=r --
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