HomeMy WebLinkAboutSubcontractor AgreementPERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT -
SUB -CONTRACTOR AGREEMENT
have agreed to be
( ny Name ndividual Name)
the /Gl/J7//fcf/ Sub -contractor for
(Type of Trade) ® (Primary Contractor)
For the project located at ��J /�S C f D I� ./�z 3/ /;7
(Project Street Address or Properly 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.
C CTOR S G TURE ((jualifier)
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of�.AI� t�C
The foregoing instrument was signed before me this (- day of
20 �/ by
who is personally known _or has produced a �Tu —
as identification.
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STAMP
Signa ut re of Notary Public
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Print Name of Notary Public
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Revised 11/16/2016
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UB-CON RA OR SIGNATURE (Qu lifter)
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PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of��cff
The foregoing instrument was signed before me this 7 day of
0C i� , 20Aby
who is personally known _or has produced a b�==
as identification.
-ice- `Ui STAMP
Signature of Notary Public
Print Name of Notary Public
In
<PaYP�a�, HEATHER BURFORD
ae State of Florida -Notary
# GG1 public
83217
My Commission Expires
February O6, 2022
PERMIT # ISSUE DATE
the --, /LG 7` e
(Type of Trade)
For the project located at
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
Name)
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Sub -contractor for
(Project Street Address or Property Tax ID #)
P unary Contractor)
have agreed to be
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.
n �
TRACTO GNATURE (Qualifier)
PRINT NAM
COUNTY CERTIFICATION NUMBER
State of Florida, County of LrU ,G
The foregoing instrument was signed before me this, day of
l.J0, 1�— , 20 S( by
who is personally known or has produced a
as identification.
AIL4 STAMP
S nature of Notary Public
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Print Name of Notary Public
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-CONY TOR SIGNATURE (Qualifier)
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COUNTY CERTIFICATION NUMBER
State of Florida, County of �u-e
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