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PERMIT # �'J ISSUE DATE
(Type of
i
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
i
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
i
Name)
Sub -contractor for
(Primary Contractor)
have agreed to be
For the project located at1�`oc��lr�� ���^'����. �` ►��
(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.
CONTRACTOR,(GNATURE
(Qualifier)
V
l/Le4 /y
PRINT NAME
i
)d
COUNfiY CERTIFICATION N BER
State of Florida, County of w/
r oing instrument was signed before me this day of
2d by Y o
ho ' personally known or has produced fin, t6 /r
as identitic tion.
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Signature of Notary Pub rc
4VkM'pH IC45Y
int Name of Notary Publi
F' "°'�y AUDR6Y B. HUMPHAEY
>•��ePy��'• 72
MY COMMISSION # FF 17 9
March 6, 2019
Revised 11/16/2016 =�:4 t} :�= EXPIRES; aew
1" •' �9� Bonded ThN Notary
Public Unden+r
0SUCONTRA R SIGNATURE (Qualifier)
PRINT NAME
t tl a
C04NTY CERTIFICATIOP ERg
State of Florida, County of
The foregoing instrument was signed before me this day of
20J.6by L eV
wh personally known or has produced a C
as ation,
Signature of Notary Iful1lic� .
Print Name of Notary Pu lic
atiY ^v AUDREY B. HUMPHREY
MY COMMISSION Y FF 174772
A: ,.41 EXPIRES; March 6, 2019
e '� 9( �:• Bonded Tb. WWry Public Underwriters
YJ�ffi R�
PERMIT# ,C,80-j — 05 ^ ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to be
(Company Name/Inividual Name)
the U rnA-CA Sub -contractor for
(Type of Trade)
(Primary Contractor)
For the project located at )X) C'c�, JIC_j L
(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.'
CONTRACTO I ATURE (Qualifier)
PRINT NAME
I
COUNTY CERTIFICATION NU BER
State of Florida, County of
h foregoing instrument was signed before me this day of
20�by a
ho is personally known _or has produced a JS&r Li�
as ideuAriication. i A
of
. 4K
Print Name
AUDREYB. HUMPHREY
Revised 11/16/2016 a y; �?
r
MY COMMISSION Y FF 174772
EXPIRES: March 6, 2019
Bonded Thm Notary Publq Underwrriters
Z - ze
SUB-CONTR&C°TOR SIGNATURE (Qualifier)
PRINT NAME
COUN'HY CERTIFICATION NUMBER
State of Florida, County of to /► / .
oregoing in trument was signed before me this
20/, by
o is personally known or has produced a
!i• ADREBIHUMPHREY
MCOSSOMMIN # FF 174772% PIRoMrch019EXESa6, 2
tPubcUnderkeBondd NiP;
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M
0
•
PERMIT# _ ��CQ ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building& Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to be
(Company Name/Ilndividual Name) i
the y Sub -contractor for
(Type of Trade) (Primary Contractor)
For the project located a ,V ,1�C�CC'Sf��`—
(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.'
CONTRACT TURE (Qualifier)
PRINT NAME
SUB-CONT CTOR SIGNATURE (Qualifier)
PRINT NAME
COUNTY CERTIFICATION BER COU CERTIFICATION NUMBE ,
State of Florida, County of State of Florida, County of
e regoing instrument was signed before me this day of a foregoing instrument was signed before me this day of
2073 by e 0. 20 )9by 'Pre V L
is personally known _or has produced a (' w o is personally known _or has produced
o d
as identification. �+ as identification.
MP �Yp4*
Signature of Notary P is S nature of Nota blic
g rY g
�1A� Notary � y Print Name o-i Nota Pi lic Print Name of Note Public
AUDREYBMUMPHREY
AUDREY B. HUMPHREY.
Revised 11/16/2016 -' = MY COMMISSION # FF 174772
MY COMMISSION FF 174772 °iI '+' EXPIRES: March 6, 2019
EXPIRES: March 6, 2019
Asa '? Public Underwriters
',pp{{ n,1•` Bonded Thru Notary Public Underwriters ' of Bonded Th. Notary _ t
W
PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Company NameiTndividual Name)
the — Sub -contractor for
(Type of rade)
For the project located at )o n) As t
(Project Street
have agreed to be
(Primary Contractor)
"r*.$1!1`'D' "0,tf-'r- v:- I ,
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.
CONTRACTOff SIGNATURE (Qualifier)
aPRINAME
COUNTY E TIFIC TION NUM ER
State of Florida, County of
e foregoing instrument was signed before me this 1r/ day of
20liby
+hopersonally known _or has produced a
i
as identification.
11 P
Signature of ota blrc M
-�:K �- ,
J� —I
Print Name of Notary P blic
SUB -CONTRA R SIGNAT (Qualifier)
g 2-,\,A
PRINT NAME
C616rYVERTIFICATION NUM ER
State of Florida, County of
Th oregoin instrument was signed before me this " day ofTle1 C)
Fpersonally known _or has produced a `—,OA
as identification.
Signature o Notary Public
a2 d tiv� rce-4 n-+ Pa
Print Name of Notary P blic /
Revised 1 IA6/2016 • � rG AUDREY B. HUMPHREY AUpq�ey
MY COMMISSION 4 Ff 174T/2 %: I MYC(B, yLWP)
EXPIRES: March 6, 2019 ti ,�IPy; EXPIRMISSIOIy pF
Bonded Thru Notary Pubro Undawkers 9f,1 �' ` Bondty Tn ES March 6, pp
ti Notary publi; Un'*nniters