HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENTPERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
BY
��➢CI
have agreed to be
(Company Name/Individual Name)
the OV M b, n Sub -contractor for
(hype of Trades e)0 (Primary Contractor)
For the project located at qI
(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. ILucie County will be advised pursuant to the
filing of a Change of Sub -contractor notice. I
CONTRACTOR SIGNATURE (Qualifier)
�► I'11 u W
O
COUNTY CERTIFICATION NUMBER
State of Florida, County of �—
The foregoing instrument was signed before me this L" 1 day of
G 20J_J by ehc ro n Kli I c\ 1
who i personally known or has produced a
as�identtiification.
— , w_ l/if/�/� �6 ! STAMP
SiWature of Notary Public
�,,'(Jr1(_1 a l Ce-u_rs'
Pn t Name of Notary Public
41e I Notary Public State of Florida
Revised 11/16/2016 . Victoria Laws
My Commission GG 197151
1oraj, Expires 03/15/2022
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SUB -CONTRACTOR SIGNATURE (Qualifier)
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of 0
The foregoing instrument was signed before me this 211 day of
who i personally known or has produced a
as identification.
/ Z le,�,4 STAMP
Si&dTWe o otary Public
�Z' C �I a 11(�W S
Print Name of Notary Public
R�� Notary Public State of Florida
Victoria Laws
G c My Commission GG 197151
q�d' Expires03/15/2022