HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENTi
PERMIT # I�,� ISSUE DATE
the C-,- I e 611-r
(Type of Trade)
For the project located at
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division :SCANNED
BY
i BUILDING PERMIT St Lucie Countv
SUB -CONTRACTOR AGREEMENT
(I
I� Ij have agreed to be
ha Name
Sub -contractor for
j (Primary Contractor)
or Property Tax ID #)
f� g�z
It is understood that, if there is any I hange of status regarding our participation with the above mentioned
i
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.
i
osTi2A`CT IGNAT E (Quali i
�j )
PRINT NAME
COUNTY CERTIFICATION NUM ER r
State of Florida, County of
Theforegoinginstrument was signed before me this i day of
0 / ' 20 by r/% A'lc-
who is pe sonally known _or has produced a
as id fficatfon.
' '4'k"tJAMP
Signature of Nota r
Nic
o
Print Name of Notary Pu r
is
r Pl"''•., AUDRE` IL HUMPHREY
MY COMMISSION 6,FF 120 92
EXPIRES: Underwriters
% r; s? Banded thfuNefaryPubrw
Revised 11/16/2016 ��Rf�ti"`
SUB CONTRACTOR SIGNATURE (Qualifier)
PRINT NAME
N *—.
CO Y CERTIFICATION
==CNo
State of Florida, County of
The foregoing instrument was signed before me this �� day of /
2( 3by i r' /V e,
who is rsonally known _or has produced
as identification.]
Signature of Notary PtWic
Print Name of Notary Publj
AUDREY B. HUMPHREY
�4�r Py "•"':
*, t: MY COMMISSION # FF 174772
' EXPIRES: March 6, 2019
Q9a Banded Th a Nota y F ubr�c Undeiwiiters
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