HomeMy WebLinkAboutSubcontractor- Update owner builder PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
iCOUNTY
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
A0114-4-6-L have agreed to be
(Company Name/Individual Name)
the fl It ,.,7 Sub-contractor for
(Type of I rade) (Primary Contractor)
For the project located at
(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.
Vol,ag�
CONT CTOR SI AT (Qualifier) SUB�ONTRACTOR SI A (Qualifier)
PRINT NAME PRINT NAME
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER
State of Florida,County of�' 1_1_71 y. State of Florida,County of 5(d C
The foregoing instrument was signed before me this day of The foregoing instrument was signed before me this day of
20 Z(by S ,20 V by
who is personally known has produced a who is personally known ✓or has produced a
as identification. as identification.
&".0, STAMP STAMP
Signature of Notary Public Signature of Notary Public
Print Name of Notary Public Print Name of Notary Public
,unp
♦tP.aY PVe/� HEATHER
HEATHER BURFORD - of FloridaBU ORD
1PPYPUB � (:-'SCornmis �GG ry public
Revised 11/16/2016 __° -State of Florida-Notary Public Wo ,,o,. sion#
Commission #GG 183217 �''�� t°° M FCommission Expires
My Commission Expires '� ebruary 06 pre
"` February 06, 2022 12022
PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
Co Hy;n\ have agreed to be
(Company Name/Individual Name)
the �_ ' Sub-contractor for
(Type of Trade) �--�I (Primary Contractor)
For the project located at
(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.
1
TOR SIG URE(Qualifier) SU ONTRAC ORS NATURE(Qualifier)
Cor
PRINT NAME PRINT NAME
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER
State of Florida,County of 5. LuG.1 C State of Florida,County of
The foregoing instrument was signed before me this day of The foregoing instrument was signed before me this L day of
20l ,,by J ,204 by
who is personally known 4'—orhas produced a who is personally known or has produced a
as identification. as identification.
STAMP 144� STAMP
at Signure of otary Public Sign ture of rqotary Public
&64 , XaW__ a—� .�
Print ame of Notary Public Print Name of Notary Public
`irnr a'o.
HEATHER BURFORD ;� HEATHER
=o�""r Pill, of Florida-Notary Public :State of plorideBVRFORD
•; Commission #GG 183217 Commission Notary public
My Commission Expires ''o,°;,;;,,r`� My Comm, GG 183217
Revised11/16/2016 �h�a,�°e`: mission
� February 06, 2022 February 06 Expires
2022