HomeMy WebLinkAboutSUB CONTRACTOR APPSPERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
' 1 J - `- Building & Code Compliance Division
•
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
(Company Name/Individual Ndme)
the le -LIE C%Tt C
(Type of Trade)
For the project located at
(Project Street Ad
have agreed to be
Sub -contractor for 1!:O�x 14ytieJ' 9/ p�S
(Primary Contractor)
4"/ • "'� FG
Property Tax I D 9) -?5<3 Daa6 • 44 D
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
tiling of a Change of Sub -contractor notice.
CONTRACT R SI .:.Tl'R ( alifier►
PRINT NAME
<2 0I s h96 9s��
COt'N'rl CERTIFICATION NU.NIB1 R
Stale of Florida, Countv of
The foregoing instrument was signed before me this _1z day of
__14he1d11__ 2o9___?fti ,leYA� FlC�1%�1
who is personally known I/ur has produced a
as identification.
STA►1P
Signature otary Public
Lz_ D X/�
Print Name of Notary Public
.0y'k, Nrlary PuUic S:a.a of Florida
Lori A Mox;i-y
My Gnmfnir,sion GG 28ol48
Expire3 11l2i312(Y12
Revised 11/161_'(716
St'B-CON I'RAC O
SIGNATURE (Qualifier)
A91'c%
PRIM r NA.l1E
��000a7o7
COUNTY CERTIFICATION NUMBER
Slate of Florida, County ofT��/
r.i
The foregoing instrument µ'as signed before me this 3 dap of
2ilar by
who is personall}known Lur has produced a
as identification.
STAMP
Signature ojXotary Public C J
z on ' / - ,r/ ,
Print Name of Notary Public
ter N'. Notary Public SlAta of Florida
Lan A Mox1ey
My Commission GG 280148
w'n. fr E>:pires 1112W2i122
PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
- Building & Cade Compliance Division
Millik
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Pz_ml/�,ps it �z6� have agreed to be
(Company Name/Individual Name)
the Sub -contractor for Z5�a_ x ��l/g1,�
s x k�ls (Type of Trade) (Primary Contractor)
For the project located at
(Project Street Address or Prope Tax ID 0)
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.
CONTRA TOR IGNAT 'R (Qualifier)
Rill F-16AYAW --
PRINT NAME
COUNTY CERTIFICATION�Nt'17BE
State of Florida, Countv of
t�
I'he foregoing instrument was signed hefore me thiisi day of
, 2Q� , by &
who is eFse�raf _ :Howl or has produced a
as identification. �/t�jw
�T Y ,1»"`�y�1 STAMP
Signature 4A"otary Public
Print Name of Notary Public
V,�y�cv am Nrt2ry Pub?ic Sii,tq of Ronda
Lori A M1ox>ey
o My Commission GG 280148
Expirun 11/28121122
Revised
, ; 7
SUB-CONT iO R Ic TLr (Q lifier)
/cw �� 'i
PRINT NA'*IE
C' Pe
COUNT't' C:ERTIFICATION" Nt'**IBE:
State of Florida, County of
r�
The foregoing instrum�enntt/was signed bef�orre me this & day of
w ho is. srrnal _or has produced a
as identification.
STAMP
Signature pf Notary Public
GD�i D
Print Name of Notary Public
s ��as' "�
Wt.ry PUbfic .Strata of Flo da
""... .
Lori A Mo;,Oey
<_�3�, c
IJIy Commission GG 280148
'fc71t4'
Expires 11123/2D22
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