HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENTthe
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
p%,-JI , 4' K� ,Qde
(Type of Trade)
For the project located at
have agreed to be
idual Name) U p0,7 �i rri Sub -contractor for J
(Primary Contractor)
(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
COIdT12ACTOR SIGNATURE (Qualifier)
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PUINT NAME
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COUNTY CERTIFICATION R NUMB �� + ' 2`
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State of Florida, County of
S -CU CfOR SSIGNATURE (Qualifier)
POL t 0669
PRINT NAME
C'eC IO f1
COUNTY CERTIFICATION ER
State of Florida, County of
he foregoing instrument was signed before me thi%_-> ([day of The foregoing instrument was sigy&d before me th S5 day of
2017by �� T - 20�, by
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who is personally known or has produced a who is personally known !or has produced a
as identification. 014 • �e-' as identification. /IDG
STAMP
Signature of Note ublic
Print Name of No ry Pu c
Revised 11/16/2016
34 STAMP
Signature of Notary ublic�
A�...f
"' C i PriNotaryPublc
KAREN S. NIELSEN
Commission N FF 11563
*' My Commission Expires
�;•..,,,�a�;.� June 12. 2018
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1hITY -
F L O-R [ D A
Pf l."'u
(Company Name
the, U� �C
(Type of Trade)
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division .,.,�. IV
F�ED
BUILDING PERMIT d 6 �(n%
SUB -CONTRACTOR AGREEMENT OCT
PERMITTING
St. Lucie Cour,iq, FL
` have agreed to be
vidual Name)
Sub -contractor for
(Primary Contractor)
For the project located at
(Project Street Aaoress or rrupwv •— -
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 NACOUNTY J �p ATION `'�
RT/ I)(— �f t��ER
i
State of lorlda, County of
Th for oing instrument was signed before me this day of
204, by
who is personally known _ ur has produced
as identification.
lie
I STAMP
Si ature of NotaryPu
1/ 'n i l
Pfin ame of Notary Public
KAREN S. NIELSEN
.'.°` Commission & pF 115 637
�' •=
ivln Expifes
Y Contmtssio
June 12, 2018 '
Revised 11116R016
7
COUNTY CERTIFICATIONCNUMBER
�
state of Florida, County of 2 *
nt was signed before me this 6]I day of
Theforegoin g instrume�
20� by
who is personally known _,& has produced a
- - --I.. '
STAMP