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HomeMy WebLinkAboutSubcontractorPERMIT # ISSUE DATE COUNTY F L C R 1 D A —446 PLANNING & DEVELOPMENT SERVICES Building & Code Compliance Division BUILDING PERMIT SUB -CONTRACTOR AGREEMENT have agreed to be (Company Name/Individual Name) ,,,�� the � � �' � r� a ; / Sub -contractor for X �' f%a,� j/�� .� ul l/-i n (Type of Trade) (Primary Contractor) n For the project located at ��� '� _S' 01 J�t1 �� + 3 y q: / (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. CO, ACTOR SIGNATURE (Qualifier) t = C S PRINT NAME C— CERTIFICATION NUMBER State of Florida, County of (. The foregoing instrument was signed before me this day of I i r d , 20" by who is personally�-known or has produced a as identification. lY, A i/t) ��✓ STAMP Signature of of ry Public\ `jam Print Name o Notary Public State of Florida z: Ginger Williams o` My Commission GG 218930 r fov nor Expires 05/16/2022 Revised I1/16/2016 SUB-CONTRACTO IGNAT (Qualifier) PRINT NAME 13-v O,q COUNTY CERTIFICATION NUMBER State of Florida, County of J4_6 The foregoing instrument was signed before me' this 4 day of 20)—b � ' 2��' ' .JM / i 1 L who is personal) own or has produced a as identification. STAMP SignatttiIre of Notar ub 'c Print Name of tart' Public _ 0 05vi� Notary Public State of Florida Ginger Williams F� My Commission GG 218930 ;a randy Expires05/16/2022 PERMIT # ISSUE. DATE PLANNING & DEVELOPMENT SERVICES Building & Code Compliance Division BUILDING PERMIT SUR-CONTRACTOR. AGREEM -ENT � I Q'!' -Gas . ! � �7_t_Ce- - have agreed to be ompany, IQanrc/Ind�idua[ Nat��c) J / i LC r, le 1� I _ Buis-eoritrctcse for ,�Yt( I ► tain (Type of Trade) (primary Contractor) 4 L For the project locatet� �t . )_/V _C (' ear) Street Address or property Tait W It is understood that; if there is any change of status regarding our participation with the above mentioned projects the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the filing of a Change of Sub=contractor notice,. CGNITR� j R SEGNUKE; ((xisfifrer) S 0 RA 0 SIGNATURE (Qualifier) PRINT IVAMF - PRI\`T' NA ME- - -- -- C6 c, i z&n 6 33 COUNTY CERTIFICATION ti'EUMBER, State of Florida; County of nj1 (,�j�f � The forclZoing irctroment.va-q Aped hefore me thix -� day of who if persanalty !crown - t! _ or haa produced a --- _- - affi identification, f , StanfitureofNot Public 's 7 ! [_l' S Print i' Me 10o ary Public 000 e[q J Notary Public State of Florida ; Ginger Williams �$ < My Commission GG 2i 8930 -• Explfes 05/78/2022 kovimd 11/16/2016 COUNTY TY C"FRTTE ICA T EON'' NUMBER R --_—� State of vlarida� County of -* Tile before me thia day of who ifi paraonally known V or hoe ptodreed a_-__-- ae iddafificati STAMP sivat�re fart' tiC'- [girt Name of 1\10ary Public L 3 f�otary F ubliC St cit lror da Javier Santana e a My Commission GG 2387na f 3((3ir4iS 0 /i W2022 STAMP