HomeMy WebLinkAboutSub-Contractor AgreementPERMIT # 1�10_
0/7-S ISSUE DATE
r PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
P604/McgAFt_ Acbur4oE , have agreed to be
(Company Name/Individual Name)
the PLUM 01 PklGf Sub -contractor for A1,6y441Jp15V, 40ootom$
(Type of Trade) (Primary Contractor)
For the project located at 3110 Q P1691rh 676P, RID
(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.
SA M
ONTRACTOR SIGNATURE (Q a ifier SUB -CONTRACTOR SIGNATURE (Qualifier)
1q[
PRINT NAME
,Z,(e Coo
0 PC i Ll)-7c13q
COUNTY CERTIFICATION NUMBER
State of Florida, County of S�- L Lt cn $
The foregoing instrument was signed before me this2day of
20aby �kO fl _
who is personally known �Or has produced a
as identifi lion. /
STAMP
SigAstFre of Notary Public
AuEN:e, �c-)NWAO
'Print Name Public
ALIENE S. DONOVAN
►.,�a
MY COMMISSION # GG 014371
�`: EXThNRE. Public u' 20� Z,�v�lers
Re , , -O"
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of
The foregoing instrument was signed before me this day of
20___, by
who is personally known or has produced a
as identification.
Signature of Notary Public
Print -Name of Notary Public
:Wi\Ti ii
ST. LUCIE COUNW
]DEPARTNI[ENT OF COMAI NYTY DEVELOPMENT
OtUDfNO PERMIT
9U"ONTRACTOR AGREEMENT
St Lucie County Cohtmdor Certification Number.
State of Plorids Certification Number (K appocab):
t3oo Z7.6
r" t-1�L� =L.1ECfTr-%c. - t i'' rftY LLN has agreedrrto be
(corrWarryMdhriduafneme) �It atl.Fi0:f�NOiC� as" %0L-C.
the EL F—(= ' T. i C ax I sub -contractor for M10 VW%M 06-11
(type of construd m trade) (name of the pfkm emb dor)
for the project located at 31 b N)u 06W016ff 6� 66-40 It is understood that,
(street address or property tax Id
If there Is any change of status regarding our participation with the above mentioned
project, I Will Immediately advise the Community Development Department (Growth
Management bivislon) of St. Lucie County by personally tiling g Change of Contractor
Form (SLCCDV FORM No. OU-0o).
1 a. .
print name
business name:
address:
city,state,zip:
phone:
/o -2.— r-+
date
-00