HomeMy WebLinkAboutSub-Contractor Agreement PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
COUNTY ;
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
t5 ?i—A, it,-, L6 J0e ll6 have agreed to be
(Cc y e/Individual Name
the r Sub-contractor for
(Type of ra e) .(Primary Contractor)
For the project located at 3019 MAJ1011 0 rl-11 7 db® — 16
(Project Street A dress or Prop rty 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.
� G
CO SI NAT RE( alifier) SUB-C T T SIGNATUR (Qua fiery
r [' L OR-pa
1
PRIN �N�y PRINIT(�NAME
COUN Y CERTIFICATION VkIBER COUI TY CERTIFICATION UMBER
State of Florida,County of State of Florida,County o
The foregoing instrument was signed before me thi z day of The foregoing instrument was signed before me tlN day of
26)by C-• ,��'by
who is personally known_or has produced a Q who is personally known_or hasp duced a
as identification. as identification.�Q� -�
R/�
5-_&"
STANIP `T" AMP
Signature of Notary Publi Signature of Notary Public
Print Name of Note_• UgREY B- `�' E Print Name of Notary Pu is
1 G 300&1
`�SPPr vus c; Y coMMISSIUN G
EXPIRES: atch 6'2023
denvriters Y B.HUMPHREY
' PublicUn YPu AUDRE aondedThN_N_otaty `•PPP eV°,. MY CoiJIMiSSION it GG 300517
cX IRES: Zrch 6,
Bonded Thru Notary PubSc.Underwriter_i•i
Revised 11/16/2016 —,,� ,� "°'�"
PERMIT# ISSUE DATE
gw PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
have agreed to be
(C ny e/Indiv1duaI N )
e.
the ' i, Sub-contractor for
(Type o Tra e) (Primary Contractor)
For the project located at e Mr-lr �E/l, .
(Project Street Address or Property Tax]D#)
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-c ntractor notice.
CO R SIGNATU (Qu ifier) SUB TOR IGN URE( ualifi
c RV c
. � a
Z-,�n 022—
PRINT NAME- PRINT NAME
COUNTT CERTIFICATION NUMBER l COUNT CERTIFICATION DUMBER
State of Florida,County of— \s\\ 1 State of Florida,County of s 1\il �V C
The foregoing instrument was signed before me thi ,^�day of r� The foregoing instrument was signed before me thi�day of
2 by e by ,(�
who is personally known or has pr uced a who is personally known_or has produc d a
as identification. as identification.
6' `W�
/ STAMP &7"&
Signature of Notary P li ��// Signature of Notary Pu li)
,N' � (Z h�
Print Name of Notary Pub c Print Name of Notary Public
REY B•HUM4HRE 0817 AUDREY B.NUMPHREY
D PY PU"
=�{P,....LO
A�oMM1SS10N dl GG 023 �+y * MY COMMISSION GG�23
EXPIRES:March 6,
*= MY EXPIRES Mal '•."w• �Zc PublicUndensiters
Revised 11/16/2016 *: :a- f�nFc.��; BondedlhruNotary ,
•;7f1 F�.' lion •I.a"' -
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