HomeMy WebLinkAboutsubcontractorPERMIT # W - oaq ) ISSUE DATE
COUNTY
F L O R 1 D A
91
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to be
(Company Name/Individual Name) II ,,--�--
the 9& - ( -o L Sub -contractor for Soy GA � r Caa rc i a ,1 c,
(Type of Trade) (Primary Contractor)
For the project located at
(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
tiling of a Change of Sub -contractor notice.
CONMACTOR SIGNATURE (Qualifier) SUB -CONTRACTOR SIGNATURE (Qualifier)
PRINT NAME PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of6� � "-r—
�The foregoing instrument was signed before me this
he
L` � L 2Q, by
who is personally known _or has produced a _
as identification.
Signature of Notary Public
Print Name of Notar'yi biic
o day of
01-5
COUNTY CERTIFICATION NUMBER
State of Florida, County of �� {
The foregoing instrument was signed before me this tCI day of
IV20 AY
who is personally known _or has produced a
as identification.
STAMP &A4!� STAMP
Signature of Notary Public
Print Name of Notary Public
Revised 11/16/2016BURFORD
tPRV PLB �i
2° State of Florida -Notary Public
Commission # GG 183217
%OF F�OP� My Commission Expires
February 06, 2022
HEATHER BURFORD
State of Florida -No
tar
Q, Commission # GG 1 Y Public
; .... MY Commissi 83217
Februar on 2022Exp res
Y 06,