HomeMy WebLinkAboutSub-Contractor AgreementPERMIT # % � /� (� � ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
'BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
i
(Company Name/In ual Name)
the /l�� �; Sub -contractor for
(Type of Trade) (Primary Contractor)
For the project located at Wo (�- zq 09"110, ' �yc- & d a e y-
(Project Street Address or Property Tax ID #)
have agreed to be
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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.
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CONTRACTOR SIGNATURE (Qualifier)
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PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of SL . U\JClt_
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The foregoing instrument was signed before me this day of
/+� L 20 � d� by
who is personally known _)_"r has produced a
144 a400,
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SUB-CONTRAICTO GNATTUURE (Qualifier)
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RINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of ItT, W C-\ '�_
The foregoing instrument was signed before me thisAi day of
20teby
who is personally known _:&r has produced a
as identification. as identification.
ask STAMP
Signature of Notary Public Signature of Notary Public
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Print Name of Notary Public
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Revised 11/16/2016 i9'Qyp . ....
STAMP
PERMIT# / "q b ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
s� have agreed to be
the /r✓CC�-Cr"?`i-Z� Sub -contractor for
�(�T►t;rreto f,�i:ade) ..:,.�
(Primary Contractor)
For the project located at /Z C)/— 6 O 6 r- 0 1 17 000 -- O
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.
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PRINT NAME
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COUNTY CERTIFICATION BER
State of Florida, County of r
The foregoing instrument was signed before me this 'dAay�off y
20�by Ji
who is sonally known _or has produced
as id tification.
• AMP
Signature of Notary lieLIU^ ,
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Print Name of Notary ubli TTrr
AUDREYB,HUMPHREY
MY DpMM1SS10N # F612,7972
w EXPIRES: March ry PUblbUnderv+nlers
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Revised 11/16/2016
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PRINT NAME
COUNTY CERTIFICATI BER
State of Florida, County of
The foregoing instrument was signed before me this day of
20)Sby l ��
who sonally known or has produced a . J
as identification. �1
/Qa &AAA2 �• �'��
Signatu of Nottaar�yjPPuubli
Print Name of Notary Plublic
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AUDREY 9, HUMPHREY
MY COMMISSION # FF 174772
EXPIRES, March 6, 2019
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Bonded Thor Wta ryPubGcUndervrrilers