HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENTPERMIT # Z 1`1' 0 2 3 ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
-ffiyi H a� have agreed to be
(Company Name/Individu Name)
the FLEC'rTLIC Sub -contractor for -0 Vk.�°���
(Type of Trade) (Primary Contractor)
For the project located at Zy (oS JoKlu5TOp R.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.
CONTRACfQR5AGNAT1
Qualifi
-La�vy 0
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of 5� Le/(y7
The foregoing instrument was signed before me this ay. of
e5rl / t/ , 20!/
who is personally known _or has produced a
as identif ation.
STAMP
Sig ture of No a y Public
Print Name of Notary Public
HEATHER BURFORD
pY P(� �/i `=o1P BState of Florida -Notary Public
*= Commission # GG 183217
"'FovF.opP; My Commission Expires
February 06, 2022
Revised 11/16/2016
CJl1 14
SUB -CONY TOR SIGNAT (Q er)
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of S4 ",-v
The foregoing instrument was signed before me this day of
who is personally known or has produced a b/.
as identification.
Sign- re of N tary Pnbfic QQ
44A9i-&A—
Print Name of N tary Public
rra�e.acrmu�'�"
�ra... HEATHER BURFORD
"a °State of Florida -Notary Public
Commission # GG 183217
My Commission Expires
°;,`,% February 06, 2022
STAMP