HomeMy WebLinkAboutSubcontractor Agreement PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
COUNTY
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
have agreed to be
(Compa Name/Individual Name)
the ��� ,�,�, Sub-contractor for 324.0 .4 �2�` t�4�-�
(Type of Trade) (Primary Contractor)
For the project located at /�� %��_�A�fe_ Z_ 'e'
(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.
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nC TC T�2ACT R SIGNATURE Qua per) AB_ RACTOR RE(Qualifier)
PRINT NAME PRINT NAME
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATIO NUMBER
State of Florida,County of State of Florida,County of! %Ci-� 2
The foregoing instrument was signed before me this llqla
day of The foregoing instrument was signed before me this 1�day of
20 by N1 snII __ 204,by (�JUt y
who is personally known or has produced a who is personally known or has produced a n
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as identification. as identification.
STAMP o';S1f1"
Signature of Notary bhc Signature of Notary Pu lV C L I
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N O d A
Print Name of Notary li� V Print Name of Notary Public
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Revised 11/16/2016 GCtober z2 ZOEkp;res 9 y 9
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