HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENTA PLANNING & DEVELOPN[ENT SERVICES
Building &
(Co pgay Name/Individual Name)
the r ec- r.-, /
Crype of Trade)
For the project located at
C- 17:4
(Project Street Address or
It is understood that, if there is any change of status
project, the Building and Code Regulation Division
filing of a Change of sub-contrae'tor notice.
CONTRACTOR SIGNATURE (Quawler)
COUNTY CERTIFICATIONNUMBER
State of Florida, County of
foregoing'
he f mstrunzeu�,7a§ signed before me this,6,D day of
2a by - . . . \.� -
who is personally known -y—or has produced a
as identilication.
STAMP
Signature 6f Notary Public
h� 6'�uzj �-:, 6 ab i,:�. A
PriatName ofNotary Public
'ary 0 pu'W
ptlbUo 60�0 d FW!da
Keffl BudK8
M
'off M'11551op FF 978543
T
0� at
MC* 10
Revised 11/1612016 EXPOMS 054612020
OF
i Compliance Division
PERMIT
RAGREEMENT
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A@
09MMV11P
R9CEIVED
APR 2018
Permitting Department
St. Lucie County
have agreed to be
for CA-) !4 4 11 -d Ae 41 C- &Z—^ e--2- 72-c, e/9
(PrimarY Contractor)
Tax ID #)
our participation with the above mentioned
St. Lucie County will be advised pursuant to the
4WICW40ACTOR SIGNATIM (Qualifier)
ya ".Ir
PRINTNAW
COUNTY CERTIFICATION NUMUR
State of Florida, County of-�A
1 e foregoing instrument was signed before me this2!
��' \ 2611bby
who is personally known -V--or has produced a
as identification.
I
4S'atlure�OrNotary�Publlc STAMP
Print Name of Noitar-j-Public 6
LAUqA & WbIDEDGE
C.OMM18810n # GG 022076
ExPli68 OUR 21,2020