HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENTSCANNED
PERMIT# /� J �� St LU I@IliLTE
a
�epa�oG'ot
R eC SX��g ee Co�rty
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
I Is r
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
I
JSCrw«ts
have agreed to be
(Company Namehndividual Name)
the PG V M �j/ic! Su'b-contractor for ,444MIZ CCW57 /n �T/Or ti L
(Type of Trade) (Primary Contractor)
For the project located at 4 #1 d N �
(Project Street Address
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 -con actor notice.
CONTRACTOR SIGNATURE uallfier) SUB-C CTOR S GNA ua
PRINT NAME
COUNTY CERTIFICATION NUMBER,,
State of Florida, County of S� t uk -�
The foregoing instrument was signedbeforeme this day 1of
� 1
,20fl by �ff`nfl�►�1Oi� �� ��
who is personally known or has produced a 1� L o 1
asidenfd'icatio
STAMP
Signature of Notary Public
� ram
HN
Print Name of No rgz ;State of Florida -Notary Public
*= Commission # GG 270079
My Commission'Expires
October 22, 2022 - _
Revised 11/16/2016
ZtrIASIOM t
PRINT NAME
a94s0
COUNTY CERTIFICATION NUMBER
State of Florida, County of tAil
The foregoing instrument was signed before me &QD[ay of
201,%y
who is personally !mown or has produced a
as identification.
Fif UXY�_���� STAMP
Signature of Notary Public
Print
tia-Y P.�i, ELL VAUGHN
" State of Florida -Notary Publi
*= Commission # GG 270079
My Commission Expires
October 22, 2022