HomeMy WebLinkAboutSub-Contractor AgreementPERMIT # ISSUE DATE LA I l-LA 0
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
o,i'(,( I a o (AxL have agreed to be
(Company Name/Individual Name)
the Sub -contractor for
(Type of Trade) J (Primary Contractor)
For the project located at
=t Nuu- R 30 SX
(Project Street Address or Property Tax ID #) Zy Zi .. l0U 5
r,
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.
VyA a. ra,, L P o c�,c/(Z e
NTRACTOR SIGNATURE (Qualifier)
�PRINTNANM
COUNTY CERTIFICATION NUMBER
State of Florida, County of
The foregoing instrument was
was signed before me this d' day of
2�1_, by
w is personally knowor has produced a
STAMP
:,......1+,
LAStW'gJAINGWIIaAH W
W COMM SSIOid # GG 275060
EXPIRES; December 20, 2022
•;�� ;Y� Ba►Oed7MtNotaryPub�cUndenrrlters
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.
Signature of Notary Public
Print Name of Notary Public