HomeMy WebLinkAboutSub-Contractor AgreementPERMIT# , y�/t,� , ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
(Company Name/Individual Name)
the Sub -contractor for
(Type of Trade)
For the project located at
&P1 6A_J
(Project
(Primary Contractor)
Z S�/" Ao-,-e , 1-2
Address or Property Tax ID #)
AUG ; 5 2111'
PEFsiMI-CiNG
S.t. Lucie COUnty, F:_
have agreed to be
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.
CONTRACTOR SIGNATURE (Qualifier)
_17—
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of '/_
The foregoing instrument was signed before me this /Ay of
Af 20/7 by e%%& a/i11VArE
who is personally known or has produced a L
as identif►cg on.
Sign tare of Notary Public
Print Name of Notary Pu
KAREN S. NIELSEN
S
_ Commission it FF 115637
* *-
My Commission Expires
June 12, 2018
Revised 11/16/2016
41
SUB -CONTRACTOR SIGNATURE (Qualifier)
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of J 'I GAG/L' L,
The foregoing instrument was signed before me this day of
y ,�,fs 20_1 by f�MJl f d
who is personally known or has produced a L
as identification.
STAMP
Signature of Notary lie
Print Name of Notary Public
KAREN S. NIELSEN
"* *=
Commission # FF 115637
grt�pi �o,.c My Commission Expires
„� �;; June 12, 2018
PERMIT# 0. ®-�Q (S ISSUE DATE
3r, ax h PLANNING & DEVELOPMENT SERVICES
°� Building& Code Compliance Division
p
BUILDING PERMIT. �� ;� �;
SUB -CONTRACTOR AGREEMENT,
PERFOHI-TING
St. Lucie Cot!nty,, F-
Y 2� have agreed to be
(Company Name/Individual Name) q
the ' Sub -contractor for
(Type of Tra (Primary Contractor)
For the project located at
6:�'l
(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.
CONTRACTOR SIGNATURE (Qualifier)
PRINT NAME
COUNTY CERTIFICATIOW NUMBER
State of Florida, County of�e, �L
The foregoing instrument was signed before me this day of
�i ril5 2017 by1�
who is personally known or has produced a
as identification.
I
STAMP
Signature o o a ub �c
Print Name of Notary Public
8/C`
KAREN S. NIELSEN
lOP
Commission # FF 115637
My
s
Commission Expires
N
11111.``
June 12, 2018
Revised 11/16/20A
6z: �) 6 41,� �
SUB -CONTRACTOR SIGNATURE (Qualifier)
PRINT NAME
COUNTY CERTERCATIOIN NUMBER
State of Florida, County of LSt G NG�
The foregoing instrument was signed before me this /" day of
2017 by k0J10 ' f CIA.IVAK
LI-1 who is personally known or has produced a Q
as identification.
STAMP
Sign ure of Notary Public
Print Name of Notary Public
L
EN S. NIE
LSEN
Commission # FF 115637
My Commission Expires
F ° '° June 12, 201 8