HomeMy WebLinkAboutSUBSPERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
C (. t' ,( r • " `ti have agreed to be
(Company Na e/Individual Nate)
J �.
the �ylSub-contractor for p S 6 f �r
(Type of Trade) 21(Primary Contra tor)
For the project located at
(Project Street Address or Property Tax fD #)
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.
t
CONTRACTOR SI�IV41TURE ((Nalifier)
TF'C V-,I 1
PRINT NAMM�
COUNTY CERTIFICATION NUMBER
State of Florida, County of , U'_)CA C
The foregoing instrument was signed before me this day of-
---tY�fa�Y-,1�
20 iby /
who is personally known )II -or has produced a
as*
tiff anon. '
�t�^ , r%r/ STAMP
Signature of Notary Public
Print Name ofN'otary Public
y' Notary Publk State of Florida
3 Christine A. Marsh
_ �3` My Commission HH 026766
��oraa Expires08/02/2024
Revised I Ilt6/2016
or ,l ' �
SUB-CONTRACTO IG ATURE ualifier)
Zt�! lA0 X
PRINT NAME
Q�3�
COUNTY CERTIFICATION NUMBER
State of Florida, County of
T e foregoing instrument was signed before me this day of
:A 201I by V j� V�LX k(_
who is personally known or has produced a
as ide itCation.
% r
STAMP
Signature or Notary Public
-A k Vy) V� Q r
Print Name of Notary Pu lic
=E2,M2
fir
l�c State of Ftoritla. Marshsion HH 026766022024
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the
PERMIT #
ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
]3Ul1dln1g`e' Code Cva"iakriiau� c LIYiJIUll
/ 4, J,- e e 72
(Company No me/Individi
(Type of Trade)
For the project
It is understood th
project, the Buildi
filing of a Change
a�-3 ->>
COUNTY CERTIFICATI
State of Florida, County o
ThhF foregoing instrument
, 20 3
who is personally known
as identification.
Signature of Notary Publi
A
Print Name of Notary Put
Revised 11/16/2016
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
!Pober7` 7 a yu
Name)
have agreed to be
Sub -contractor for {0001 S 6 � t2 e 1 c
(Primary Co. actor)
at
(Project Street Address or Property Tax ID #)
if there is any change of status regarding our participation with the above mentioned
and Code Regulation Division of St. Lucie County will be advised pursuant to the
Sub -contractor notice.
as signed before me this day of
by
J�er has produced a
W5
f(
SUB -CON R ONATURE (Qualifier)
J err
PRINT NAME
98 y?
COUNTY CERT ICATION N
UMBER
+
State of Florida, County of ' 1 (M A1_
Th fore�g(o�ing instrument was signed before methiday of
�1% , 20,, by y
who is personally known —ILor has produced a
as identification.
STAMP STAMP
Signature of Notary Public
Print Name of Notary Public
s y Pug, Notary Public State of Florida
r° ce A Thomasina Bowins
v My Commission GG 201733
Expires 03/29/2022
of
Notary Public State of Florida
4^ A Thomasina Bowins
My Commission GG 201733
N.1.0,Expires 03/29/2022
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