HomeMy WebLinkAboutSub-Contractor AgreementPERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
. Building & Code Compliance Division
&'Kr)dA 1R. 7\ h
V
pa ame/In tvidual Name)
the �i�l �► ��'N
(Type of Trade)
For the project located at
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
(Project Street
/' c--\,/I
Sub -contractor for
have agreed to be
(Primary Contractor)
br Pork P 1'�ar(2 �V%�
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.
11!ON RACTOR SIGNAT E (Qualifier
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of ' Q
The foregoing instrumentwassin before me, this
�1 l day of
20GQ , by
who is personally known _or has produced a
as identification.
)I, v i STAMP
Signature of Notary Public
in Name of Notary Public
': �SWUINAlNGRgM.RgHNG
±Fa Q:�`' EXPMY
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Revised 11/16/2016
SUB -CONTRACTOR SIGNATURE (Qualifier)
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of
The foregoing instrument was signed before me this day of
, 20_, by
who is personally known _or has produced a
as identification.
STAMP
Signature of Notary Public
Print Name of Notary Public