HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENT
PERMIT #
ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
_____________________________________________________________________ have agreed to be
(Company Name/Individual Name)
the __________________________________ Sub-contractor for ____________________________ (Type of Trade) (Primary Contractor)
For the project located at __________________________________________________________________
(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) SUB-CONTRACTOR SIGNATURE (Qualifier)
__________________________________________________________ ________________________________________________________
PRINT NAME PRINT NAME
__________________________________________________________ _________________________________________________________
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER
State of Florida, County of ____________ State of Florida, County of ____________
The foregoing instrument was signed before me this _____ day of The foregoing instrument was signed before me this _____ day of
_________________, 20___, by _________________________________ _________________, 20___, by ________________________________
who is personally known ____or has produced a __________________ who is personally known ____or has produced a _________________
as identification. as identification.
_______________________________________________ STAMP _______________________________________________ STAMP
Signature of Notary Public Signature of Notary Public
_______________________________________________ _______________________________________________
Print Name of Notary Public Print Name of Notary Public
Revised 11/16/2016
Seann Gates Kevin Stirn
CVC57002 EC13007122
Hillsborough Hillsborough
18th 18th
December 21 Seann Gates December 21 Kevin Stirn
DL DL
Genesis Electric Services LLC
US SolarElectrical
7804 San Carlos Dr, Fort Pierce, FL 34951
Jason S. Monchgesang Jason S. Monchgesang