HomeMy WebLinkAboutSubcontractor Agreement}
PERMIT-# ISSUE DATE
-03.3
. ;i
! PLANNING. +& DEVELOPMENT".ERVYCES
Building &Code Compliance UvWon
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BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
i� a l-._�` n {-",,�, i _ Se VV; L.have agreed to be
(Company Name/ Individual Name) "
the A ec�--rt'C5 �_� . Sub -contractor f r � 'I�-r S -
._..W.......
(Type of Trade) (Primary Colitractor). l
For,, the tc act located at 3V i a 5�-_ +z
f (Ptqlea Street Address or Property Tax ID, 4} "
It Is understood that, :if there "is any change of status regarding our participation with the above mentionei
project, the Budding;and -Code Regulation Division of St. Lucie. County will be, adyised"pursuattt to the }
filing of,a�Changerof:Sub contractor notice'.
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CONTIiACr R SIGNATURE�(Qualifier) SUB -CONTRACTOR -SIGNATURE (Qualifier)
PRTN;r AM' PRINT NAME9/5
COUNTY CFRTIFICA'rTOiv Nli1gBER T07VNTY CERTIFICATION NI NIRR
State'of Florida; County:oc_.4k"`i. State of Florida, Comity of J !
The "fore om instrument was signed before me thisday of " T;he,foreroing instrument was signed -before me this"; chII of
h 2U1'.b}�.-�61 ydd—✓ 2JU by AY
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who is persoti lly POWRI has produced a who is personally kno+i aor has produced a
�ns,id h6catilllon: as id tiellemi'i.
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STAMP � STAINIP
ignature of Not . • Pu lie: ignature of:Nnta ublic
k11V LA
ffloNe
• 13.
Print-NameofNota y Public Print-,Yame�of, tiotary Public �
,,fin Notary Public State of Florida "
�P Tracey R Mascola Nosy Public State of Florida 1,
W Commissitxt GG 958134 1=
"� Kimla J. Simone 1
«t Expects 04f28/2024 :� p my �ommiedon GG 957803
d,
Expiroe05L1a12024;
Revised 11/16/2016
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