HomeMy WebLinkAboutSubcontractor AgreementPERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
I . i n- a— AC LoxG4 have agreed to be
(Company Name/Individual Name)
the ele�CcA Sub -contractor for
(Type of Trade)
(Primary Contractor)
For the project located at 17 ' eO& f'GLcfTI G
(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 SIGNATURE (Qualifier)
7 v�Me u1
PRINT NAME
COUNTY CERTIFICATION ®NUAMBER
State of Florida, County ofst-.A r - o . �p
The foregoing instrument was signed
�before
� me�th�is's -1(� day of
�, by X`_ %t�1
who is personally known _or has produced a
as jatification.
STAMP
Si atu �a ubhc
Print Name of Notary Public
as•.....
U M M INGRAMAAMNG
..1 W COMMI$M 0 GG 275060
EXPIRES December 20, 2022
Bonded7taHclaryPubli WWeWtere
Revised l
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
Name of Notary Public
STAMP