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HomeMy WebLinkAboutSubcontractor 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 for ZG�/✓ �� �� r�� (Type of Trade) (Primary Contractor) For.the project located at e' /'✓�wZ42 (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) l iepm z �� rn oil i��' r �o�aral l�'�iCh ,ccc e PRINT NAME' PRINT LNAME COU Y CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER a State of Florida,County of 1 L a. State of Florida,'County of e foregoing instrument was signed before me this day of The oregoing instrument was signed before me this,,day of !!�yl_e� l�w /► ,20�yi�-�o is personally knor has produced a 1 � (` h s personally(mown or hasci:d��S as identification. as identification. TAMP Sign are of otary He W Signathfe of Notary Publi Print Name of Notat Pu J Print Name of Notary P lie WORE B AUDR`:'/B.HU1vIPHREY { ADD GG300817 �.. ::':,,:.:: 1= ;'',1i.'' :k UN,WNi\dWSIUN#�GG 30081? i� aP:....•4� Ott CCj (�71J U>��k V (. '��.^ - S1 Revised I t/16/2016 _ �(� �' Larch 6,20- } 5 _ r EYPIRES:tviarch 6,2023 E;;PIREs:ti 1,u41icl{ndenMcilers ,...,'•; . Unden:rits;s '-.,.• .�;,.•.�: �UTletatY �-- r.. `,,;=.� [?ended7hrutlotaryPa ...-._..., ,�F,jp:','.' �^� '�A`�� t� R:.�•4�'/�yiSC.C3UA Y']LYl1 PERMIT# ISSUE DATE PLANNING & DEVELOPMENT SERVICES Building &'Code Compliance Division COUNTY BUILDING PERMIT SUB-CONTRACTOR AGREEMENT s have agreed to be (Company Name/Individual Name) the �f�7i�� 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) �C aPRINT ��o1 4JlSCa co PRINT,lee g M- M-0 NI.S-aa C U . _ DV COUNTY qtkTIFICATION NUMBER COU Y CERTIFICATION ER- State of Florida County of a ,) t State of Florida,County of The foregoing instrument was signed before me this day of T regoing instrument was signed before me this day of 2MbyL0Xr7Aka zo _ ' C 0 y L C p1L r� ersona known or has produced a Jo!rsonally known_or has produced.a 1 G p 11Y p as identification. as identification.11ud AMPAL-fr"&AMP Ttg—natuffi of Notary Pub-IliSignature of Notary, lic c ►Ne:F m h r Pm rt Name of Notary Po lic Print Name of Notary ublic a30R�N�N���GG OOg1l :O•lrP�1�(G1�Za��S`��t�h,6 UnOde,a,�eca ' �- A'�DyyRppk S6�Ob1���C•'�30031T :2: 1 Cn6 20•. r.• c i �. Pf `,, de�jh0 ! , ..: ih CXo1R�S:iv4aS M,.lcU13e �els— Revised 11/162016 -.,,�.c�•�: 6cn� _a; fit, ;�; Thahoiary� `