HomeMy WebLinkAboutAC SUBPERMIT # ISSUE DATE
COUNTY
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PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
(Company Name/Individual Name)
the NyAC _MCC (.AcA CAA Sub -contractor for
(Type of Trade)
For the project located at
P l j (�) have agreed to be
HOMECRETE HOMES INC
(Primary Contractor)
5403 DEER RUN RD / 1313-502-0037-000-3
(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 Couzc will be advised pursuant to the
filing haof b-contractor notice.
CONTRACTOR SIGNATURE (Qualifier) 0��IGNATU�RE(Qua�fifier)
71w bZj - a . v
PRINT NAME fWTNAME
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CO�N�Y CCERTIFICATION NUMBER
e-�
State of Florida, County off
The foregoing instrument was si d b1eefforre ,meetthi 2 � day
of
2�, by C ' who is CP
is personally known V or has produced a
as identification.
STAMP
Tg4W.f Notary Pubin:
Print Name of Notary Public
RER
State of Florida
4 howman
ion GG 294495
Revised 11/16/2016 12023
COUNTY CERTIFICATION NUMBER
State of Florida, County
T foregoing instrument was signed before me this?� o� day of
.�
221. by VraV
l�FM1iv`r7ly" '
who is personally known _or has produced a
as identification.
LISA Gl§gg.MP
Signat a otNotary Public
f__
PhY COMIJ1SS1%# GG 198185
EXPIRES: April 22, 2022
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Print Name of Notary Public