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HomeMy WebLinkAboutSub-Contractor Agreement PERMIT# ISSUE DATE PLANNING & DEVELOPMENT SERVICES • Building & Code Compliance Division w. BUILDING PERMIT SUB-CONTRACTOR AGREEMENT R�)_KA)Iv-i-q Zj P_/q1J have agreed to be �Company Name/individual N"�) the U tj Sub-contractor for '(Type of Trade) (Primary Contractor) For the project located at_13'17L) )k6baA6N�1- 6W-D Sb 26LnCzt�td��`-s 31,foqb (Project Street Address or Properly 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. 7 4TRACTOR Z_SIG NXTURF(Qualifier) SUB-CONTRACTOR SIGNATURE(Qualifier) 5�� PRINT NAME PRINT NAME — C20 L� z COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER State of Florida,County of Z54- W0-c- State of Florida,County of fflae:-h The foregoing Instrument was aimedbefore me this?,V dy.,f The foregoing instrument was signed before me this 7 day of c' 20R'by f)2kx _aOWON 202a by Jag)/ICJ who Is personally known___pr has produced a who is personally known -,/ or has produced a WR"Cab"n, as identification. 6 Notary Public STAMP Signature I of I f Grp STAMP A) Print Name of Notary Public Print Na m"0 ON 9Nowrl$64big stew of Honday 2 2, Nor�whtiejl+�eltirt GO 029907 011 022348 Revised 11116/2016 STATE PERMIT# ISSUE DATE PLANNING & DEVELOPMENT SERVICES n Building & Code Compliance Division w..:...r,..,...:,.. ..... .. ..:..UNTY BUILDING PERMIT SUB-CONTRACTOR AGREEMENT AAr""14_1� 4 m'j have agreed to be (Company Name/Individualgame) a `l the 6- e,.fi l �" l Sub-contractor for li d (Type of Trade) `` (Primary Contractor) For the project located at 15 '1'7 9 !4 W l LL>J) n L , ?� (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. ON CTOR SIGNATURE(Qualifier) S RMNATURE(Qualifier) TzU PRINT NAME PRINT NAME 6 f5 G J 2S a o - - 1,306,�--3,7, C - COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER State of Florida,County of N kt State of Florida,County of Sh i4f IL Vim'e The foregoing instrument was signed before me this Z day of The foregoing instrument was signed before me this ZP day of 202V by PO Uc� 13"'y5 SA►VAAAx ,202Lby St3w�yP�/ �i9��5 who is personally ianow-,�(_ or has produced a who is personally Imown X- or has produced a as id!ntillcation. a37F;� n. /-. j STAMP �`� STAMP lure of Notary Public Sloture of Notary Public R - Q. & -L-16P S N &/L le 1)" Print Name of Notary Public Print Name of Notary Public Notary Public State of Fbrida Mark Q GpIder5 ,y puelic Sate of Florida rs r My Commission�,G 287839 aw Exp; f`:x var2112023 . 1ff� Mark D Geiders My Commission GG 287832 Expires 0)41?92023 Revised 11/I6/2016 —' ap*