HomeMy WebLinkAboutSelph sub contractor agreementPERMIT# ISSUE DATE
COUNTY , �
e L 0 R t D A
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PE&MIT
SLAB -CONTRACTOR AGREEMENT
A/rt ` f e' k'01-1-CA I have agreed to be
(Company\lame/Individual Name)
the I Sub -contractor for �rvyk Q "l
(Type of Trade) (P mary Contractor)
For the project located at t1])- 0 a1sn4 A
(Proiect Street Address or
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
fling of a Change of Sub -contractor notice.
C Rr1cTQR�S+IGNATURE (Qualifier)
10
PRTNT NAA'I£
CPC)g51'1ly
COUNTY CERTIFICATION NUMBER
State of Florida. County of *� ` iJr✓ A ��
The foregoing instrument was signed before me this / 0_ d.y, of
AAVcy`3cy%, ,20�l,by�(J CCAt~if/'PL
who is personally known 21or has produced a
as idennfica `
A -,NIP
Signature of Notary Public
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Print Name of Notary Public in N
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Revised 11/16/2016�r'bt
SUB -CONTRACT TGNATURC (Qualifier)
PRINT NANIE
COUNTY CERTIFICATION M1'i?it BFR
State of Florida, County of 1 Y ^
The foregoing instrument was signed before me this Ir'day of
41b,/C -., tv- 2014 by �� /'I S' Z4 a AI -
who is personalty known _or has produced a L
as identifi vd,
Signature of Notary Public LL
Im
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Print Name of Notary Public N o
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