HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENT PERMIT# n j ]� ISSUE DATE
-- PLANNING & DEVELOPMENT SERVICES RECEIVED
- Building & Code Compliance Division OCT 27 Z071
BUILDING PERMIT St.Lucie County
SUB-CONTRACTOR AGREEMENT Permitting
Card I n at 0_00 8 r� have agreed to be
(Company Name/Individual Name)
the /Zo D Sub-contractor for Saah ct 1gd?1G'/ lit' &1 i9 Y'n
Me4
(Type of Trade) r1L (Primary Contractor)
For the project located at o�J�(a �� �T • Pl ef C-L
(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.
G
CONTRACTOR SIGNATURE(Qualifier) SUB- NTRACTOR SIGNATURE( aliri )
ba✓e Go lvy-) Y-07of S. 44
PRINT NAME PRINT NAME ci
C6C iso u033 gO72—
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER
State of Florida,County of G 1 Ci State of Florida,County of Cie
The foregoing instrument was signed before me this,d�y Of
The foregoing instrument was signed before me thist day of
Qchwl 20��Jby�e- �(J l I a , L 20�Iby 1: I
who is personally known '�or has produced a who is personally known_or has produced a
as id ntification. as i entification.
1 STAMP I , a STAMP
Signa ure of Notary Public Signallire of Notary Public
-JC h y>>4�61' Da vi:5 :kon J J t, �S
Print Name of Notary Public Print Name of Notary Public
$o 'rPu JENNIFERDAVIS
*_ MY COMMISSION#GG 953418
;�otVPbm�� JENNIi ER DAVIS
az EXPIRES;February 29,2024 *, ;; MY CUVIMISSION#GG 953418
Bonded Thru Notary public Underwriters EXPIRES:February 29 2024
Revised tirt, 'FOP Bonded 7hru Notary Public Underwritera
L