HomeMy WebLinkAboutSub-Contractor AgreementJ
PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
(Company Name/Individual Name)
the ';)� , 3!'r h 1,- cs V Sub -contractor for
( ype of Trade)
(Primary Contractor)
have agreed to be
For the project located at wc) s cJ4u,)a) J T), itq (4 Q1 keSC-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.
-/ CONTRACTOR SIGNATUR (Qualifier)
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of 5�' 1 „[l•�
The foregoing instrument was signed before me this �J day of
(� 20� by �v/
who is personally known _or has produced a W
as identification.
STAMP
Signature of No y Public
Print Name of rTof7y
r lic
rm
AUDREYB.HUMPHREYMY COMMISSION # GG 300817Revised 11/16/20EXPIRES: March 6, 2023rk Bonded Thru Notary Public lJnderwrilersm.., -�"
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
PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
(Company Name/Individual Name)
the L;,ter, Sub -contractor for
(Type of Trade)
For the project located at (()
have agreed to be
(Primary Contractor)
� 9�v (m FL 3q',4,3
(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 County will be advised pursuant to the
filing of a Change of Sub -contractor notice.
CONTRACTOR SIGNA RE (Qualifier)
SUB -CONTRACTOR SIGNATURE (Qualifier)
PRINT NAME
PRINT NAME
COUNTY CERTIFICATION NUMBER
COUNTY CERTIFICATION NUMBER
State of Florida, County of � Luti e
State of Florida, County of
The foregoing instrument was signed before me this day of
The foregoing instrument was signed before me this day of
, 20, by
, 20—, by
who is personally known _or has produced a
who is personally known or has produced a
as identification.
as identification.
STAMP
STAMP
Signature of o Public V
Signature of Notary Public
M b (C
• �
Print Name of Nota Pu lic
Print Name of Notary Public
AUDREY B. HUMPHREY
*. MY COMMISSION # GG 300517
4; EXPIRES: March 6, 2023
Revised 11/16/2016 i?r;
••FOF F ,Q, Bonded Thru Notary Public Underwriters
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