HomeMy WebLinkAboutSub-contractor PERMIT# 01 ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
'COUNTY
F 1 0 R I D A
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
,-aq� Ck�fi, rie
have agreed to be
(Company'�ame/lndiAdual Name) .... ..........
the Cp ),e r4,LC,,e r Sub-contractor for,Jrt
(Type of Trade) (Primary Contract6r) J
For the project located at IV Le 4T-1 , _V75
(Project Street Address or Property Tax ID 0-) 1
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.
CONTRACTOR SIG-N—iATURE(Q st,8-coNTwx(-T'0R SIGNATURE(Qu#idir)
PRINT NAME PRTNT NAME-
_(1 I, e C CMG ISa Ocal 9-4
COUNTN TERTiFicATioN♦NUMBER COUNTY CERTIFICATION NUMBER
State of Florida,County of State of Florida.County of
The foregoing instrument was sigrilO before me thijz_&day of, The foregoing instrument was signed before me this day of
20J
W.
who is personally known or has produced a who is personally known U--.r has produced a ..............
as identification. AS identification,
/-2_ STAMP STANIP
q
lignatur of Notary Public Si nutur of
tiotary Public
Name of Notary Public PrintlKame of Notary Public
m
DEBORAH1.70STIN DEBORAHLAUSTIN
commission#GG 16561
Commission#GG 165615 '
Expires January 6,2022
Expires January 6,2022
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RtV1E_ ,.0 1 68onded Tjhru Trey Fain Insurance 800-36-7019 Bonded Tlvu-imy Fain Insura
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