HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENTPERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to be
(Company Name/Indivi#al Name)
the 0Of, V-,e i�v�e, Sub -contractor for
(Type of Trade) (Primary Contractor)
For the project located at -50. ; Cl W►0,65s ('_0V1-)PI QCC rd
(Project Street Ad ess 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.
VNTRACTOR SIGN URE (Qualifier)
L/
PRINT NAME
COVNTY CERTIFICATION NIPPER
State of Florida, County ofj �ejj
T regoing instrument was signed before me this ( day of
20n, b l ( ' `
W. personally known _or has produced a K,
as identification. _ ' ]I
STAMP
�y
RM
B.HUMPHREYSION # FF 174772: March 6, 2019Revised 11/16/2016taryPublicUnderwriters
11
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COUNTY CERTIFICATION WJMEBER
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State of Florida, County of 's L C % C
The foregoing instrument was signed before me this day
'of1...p
' 20_0 by —� b r �QU � r\ p
who is personally known or has produced a
as identification.
•�rq1, ..YQ�,o:
AUDREYB.HUMPHREY
+ ` . MY COMMISSION # FF 174772
=
EXPIRES: March 6, 2019
C. g;' ; _ Bonded'ihni No,ar, Public Urdenwitere'
r— .. AUDREY B. HUMPHREY
MY C01%IMISSIOh ,
EXP!r
RnnriPd
PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Vl J have agreed to be
(Company Name/I ivid al Name). -/� j)')- y
the 1 ' Sub-contraWr for
(Type of Trade) (Primary Contractor)
For the project located at '= Il'O oVLI =' Snrj
(Project Street Ad ress or Property Tax #)
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.
COUNTY CERTIFICATION
State of Florida, County ofIZZ`
e foregoing instrument was signed before me this day of
20�, by _ \ Q- e
-r
o�-
o is personally known or has produced a
�r
as identification.
VIP
""''• AUDAEY B. HUMPHAEY
Revised 11/16/2016 ==4' MY COMMISSION # FF 174772
'* EXPIRES: March 6, 2019
Bonded Thru Notary Public Undaw tors
rONTRAMM SfIfNATURE (Qualifier)
`�yl
PRINT NAW
UV ��•
COUNTY CERTIFICATION NUM 3ER
S4State of Florida, County o_- I / `u- 't—
The foregoing instrument was signed before me this day of
20]_q by
whd is personally known or has produced a RP•5 P.
as identification. OW 0-
j AUDREY B. HUMPHREY
>1�ry,A�,,•r+a t{: EXPIRES• 1270417972
MYGOSSOaMarcrc
PoblicUndeiw�rs
Sonded'fhru Notary
s,Rf,�•
PERMIT # ISSUE DATE
(Type
For the project located at
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
rSub-contractor for
(Project Street Address or
(Primary Contractor)
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.
rTRACTOR SIGN URE (Qualifier)
PRINT NAME
CONTRACTOR SIGN (Qualifier)
PRINT NAME
L, y `1 , 4—
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER
State of Florida, County of C 1 .e State of Florida, County of
The foregoing instrument wassssigned before me this / day of The foregoing instrument was signed before me this day of
e , 20 . �0h n � e h �ti , 20 by
who is personally known or has produced a rr who is personally known or has produced a
as identification. D l._- as identification.
J1A�� STAMP
Signature of Notary blic ((( Signature of Notary Public
Print Name of Notary P blic Print Name of Notary Public
`444Y'PUp. AUDREYB. HUMPHREY
+: MY COMMISSION # FF 174772
a. ° = EXPIRES: March 6, 2019
Revised 11/16/2016 ,t .,
;AF ° Bonded Th. Notay Public Underwr ters
PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Jo
(Company Name/In1div{iiival Dame) o
the 6(A))� C f f) t 1 r�'vV_ ko"yT' ISqu -contractor for
(Type of Trade) (Primary Contractor)
For the project located at :'
(Project Street )Address or Property Tax ID #)
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.
NTRACTOR SIG TURE (Qualifier)
�R Tl ' AIE
Ii��i�1C�DV`
COUNTY CERTIFICATION NUMBER
State of Florida, County of ,,i
The foregoing instrument was signed before me this day o'fy�
20n, by bA/ ey) po �j
eC.
h is personally known or has produced a
-CONTRA OR 7
ATURE (Qualifier)
XDAU If
PRINT 1�AME
N) A
CO Y CERTIFICATION NUMBER
State of Florida, County o • 4/VUf, C
The foregoing instrument was signed before me this —1 �d, day of
Ul/Y� � , 20n, by ��� I' 7: )"" �)en PO
Pwho is personally known or has produced a P ' T�>F -
s identification.• as identification.
VAMP AMP
Signature of Notary lic {{ Signature of No Public
CA NCJ
Prmt Name of Notaty Pub ►c Print Name of Notary ublic
���`•"kart: Al1DREYB..HUMPHREY
MY CO, N ISSION # FF 174772
�•. t EXPIRES. Dlarch 6, 2019 g.
Revised 11/16/2016 d` % fl ;,R�°`' Bonded 7:,ru t urr: P�:ofc Undanvriters _.=o.
��y?� AUDREYB.HUMPHREY
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,tMISSION #f0ar1 FF 174772
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