HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENT i
PERMIT# ISSUE DATE
o �j D
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
iCOUNTY
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
to' ` Nui S have agreed to be
(Company'N !Individual Nam
the ��m�1� Sub-contractor for 1
(Type of Trade) (Primary Con ctor)
For the project located at
fit_ ��1q�sl
(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.
CONTRACTOILSIGNATURE(Qualifier) SUB-CONTRAC R SIGNATURE(Qualifier)
PRINT NAMES PRINT NAME(
COUNT ERTIFICATION NUMBER COUNTY CER IFICATION NUMBER
State of Florida,County of State of Florida,County of Sk-
The foregoing instrument was signed before
eff or`ee me this day of The foregoing instrument was signed before rme ethis � day of
,20o�(by C� fJlq jr 9-� (
C— ,20=,'by
who is personally known_or has produced a who is personally known____or has produced a �
as identificatio`n.� as identation.
V STAMP y"� STAMP
Signature of Notary Public Signature of Notary Publi�—
EjUOVCkic�hl-) DINN)rA i I C)l lf:!N
Print Name of Notary Public Print Na e o o ary u i
ELLEN VgUGHN
COdre� F 'y a:State of Florida-NbtarY Public
^, Commission #
GG 270079
C�iss�o�%VMY Commission Expires
nnn
p o �o aa, G _ Octoo0r 22, 2022
o
Revised 11/16/2016
�207�k��OtA�9 J/c
2� es
PERMIT# O t ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
COUNTY
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
CA t 1 }1 N. -Lib-s have agreed to be
(Company ame/Ind'TZ
al Nam ) ^the > . C Sub-contractor for
(Type of Trade) (Primary Con ctor)
For the project located at duct (I�
s 'WEI Pz5%a
(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.
CONTRACT IGNATURE(Qualifier) SUB-CONTRACXOR SIGNATURE(Qualifier)
PRINT NAME) PRINT NAME
n Dozk4
COUNT E TIFICATION NUMBER COUNTY CER IFICATION NUMBER
State of Florida,County of S-\—(A l C9 State of Florida,County of S�— LL 0---!
The foregoing instrument was signed before me this day of The foregoing instrument
ttyw(as signed before rmne 1thiiss day of
20 t (by l / {' ��� ,2U-,�by �l➢C ( M5
who is personally known_or has produced a j �' who is personally known_or has produced a v 04�
as identification. as ident'natio�Jn.
`
EQ STAMP `� STAMP
Signature of Notary Public V Signature of Notary Publi
Print Name of Notary Public ,�oTagYq,, Print Na►neeo-N ary u is
a. ELLEN
mo sue:S1` otMY PGB��
%•,,ii�p�°��` Cdle'� *_State of FloridaAUG HN
0 °f,�c� 9J o; Commission # GG 270079 Public
v Com�yco'sso°�:ad�'q� 0 ;; _ M _ mission Expires
Oo 'h �, br�r 22, 2022
Revised 11111/2111 f° 1b; or Gy °r�.x" 3 vim=.��w
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