HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENTj-�
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PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
MA-FOL'tJ I?4V,t=(c-
(Company Name/Individual Name)
the E JCCz6i[-AL. Sub -contractor for
(Type of Trade)
For the project located at
1,10
(Project Street
(Primary Contractor)
or Property Tax ID #)
have agreed to be
AV4 Pogrom , PL3Yg5 )
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)
J/V�—Trt� C k,) E?A V-Ee (L—
PRINT NAME ,/
COUNT CERTIFICATFO R Jr
State of Florida, County of—;.J✓��
The foregoing instrument was signed before me this day of
201n, by1��'cLeW AA
who is personally known _or has produced a
as identificati
STAMP
Signature of Notary Public
KAREN S. NIELSEN
Print Name of NotaryPu ommission # FF 115637
c My Commission Expires
June 12. 2018
Revised 11/16/2016
SU 'CONTRACTOR SIGNATURE (Qualifier)
f111M TF epi (?U p-
PRINT NAME
COUNTY CERTIFIC4TIO BEA
State of Florida, County of
The foregoing instrument was signed before me this day of
20J6by I Y LIQ" e 1J 6&6i'
who is personally known or has produced a :ELt,
as identification.
�—'— STAMP
Signature of otary ublic
KAREN S. NIELSEN
# F F 1 15(i37
Print Name of NotaryPu My Commission Expires
o„�o�°a� June 12, 2018