HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENTr ,
PERMIT # � ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
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BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT 0. 099
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have agreed to be
(Company Name/Individual Name)
the P/1&bhl,'faS,_ Sub -contractor for ��N� 1 p�� fp�l to y_1.0 S
(Type o Trad (Primary Contractor)
For the project located at
(Project Street Address or Property TaxA #)
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 CERTIFICATION NUMBER
State of Florida, County of
The foregoing instrument was signed before me this -Z daypo�f
rq
who is personallyknown or has produced a
as identification.
E� 00 STAMP
Signature of Notary Public
ELLEN VAUGHN
`20 State of Florida -Notary Publi
=* *= Commission # GG 270079
Public =.,9� _ ,oec My Commission Expires
SUB -CONTRACTOR SIGNATURE ( liner)
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of a (s1&CV1_
The foregoing instrument was signed before day of
IR� ,2oL`,�y mTC � -Ft I f'2, � 1��e�
who is personally known or has produced a (—l_ '0
as identification.
STAMP
E�tgnature of Notary Public
auj_ -
Name of Notary Public
St CaOEl
rnrn- ideAUGHN
My �ossion # GGarypubl
—0ptn m1ssion )z,—. 9
Revised 11/16/2016