HomeMy WebLinkAboutSUB-CONTRATOR AGREEMENT 6-16-17t
PERMIT# ISSUE DATE
17w�- � 6
PLANNING & DEVELOPMENT SERVICES �h
Building & Code Compliance :Division 3'
tE ti
BUILDING PERMIT ✓U�° �` ' .:
SUS -CONTRACTOR AGRI EM]ENT �Y
SG l � have agreed to be
(Company Name/Individual Name)
the C t if c. % i -; c Sub -contractor forNhAgY 6u r 8,dF>�S 5/c
(Type of Trade), (P Contractor)
For the project located.at _ f f _ GJ b O ( 000q - . 0200
(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.
�V(Qualifier)
PRINT NAW
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COUNTY CERTIFICATION NUMBER
State of Florida, County of-� . LtAa_�
The foregoing instrument was signed before me this �S day of
20 7 b
who is personally known V/y or has produced a
SUB -CONTRACTOR SIGNATURE (Qualifier)
PRINT NAME
COUNTY"CERTIFICATION NUMBER
State of Florida, County of
The foregoing instrument was signed before me ththlsAl'�r day. of
20q by
who is personally known %--o'r has produced a .
as identification. ` ^ as iden ' cation.
i `— STAMP STAMP
Signature of Public Silftuttureollsotaryrubue,
f ` 1 91 VmN L
Print Name of otary Public Print Nmme of -Notary Public
MARY ANN HOOT) '
P6e % L.ENTM0
es Notary Public -State of Florida KATHLEEN M VA
�� -�i;: ,
Commission # FF 2022fi5 s~ •': MY ;:Ural•A:SWON O FF21A40
01"�>oP- My Comm. Expires Mar 17, 2019 EXPIRES Ju p 2s.:201� ,
Revised t i/i62of6 Bonded through National Notary Assn. gas r
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