HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENT HVAC- MECHANICAL PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
-�� - Building & Code Compliance Division
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
�L (� 4N have agreed to be
(Company Name/Individ�`�aI Name)
the_�{j(� i�DIIC Sub-contractor for HOMECRETE HOMES INC
(Type of Trade) (Primary Contractor)
For the project located at TBD DYER RD I ID#3414-501-1412-100-7
(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 Coe Regulation Division of St. L4NAME
l be advised pursuant to the
fili f a Chan e of Sub-contractor notice.
/11/-7
CO RACTOR SIGNATURE(Qualifier) SIGNATURE(Qualifier)
PRINT NAME LA K05_1V_CJn
1_12g4t CfiU')5dr1g `1
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER
1�p v�
State of Florida,County of �Xk-e.J State of Florida,County
The foregoing instrument was sig d before me this day of The foregoing instrument was signed before me this day of
20c9A by �+U 1� _ � 2Q,b V"
� or who is personally known has prdduced a who is personally know or has produced a
as identification. as identification.ay_STAMP y _ s LLA2 STAMP
Signature of Notary Public Signature of Notary Public
Print Name of Notary Public Print Nance of Notary Public
0 . Notary Public State of Florida �r°`• y Pu "�': MY COMMtSSiOP!'k G"
1c.�iS5
EXPIRES:AAri122"zO22 `t
Melissa D Showman �'� *� ublicUn4.r�itiicrs
,E+• My Commission GG 294495 ' fro` Bonded rhru No1'sY P <
Revised 11/16/2016 ;4a paF Expires 01/24/2023 — `—