HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENT—
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PERMIT # ISSUE DATE
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PLANNING & D
Building & t
i%QY`re�< �i1�dt
(Co NamefIndgulllffgl 'a
the r��
(Type of Trade)
For the project located at
.,OPMENT SERVICES
Compliance Division
PERMIT
R AGREEMENT
for
Tax ID
(Primary Contractor)
have agreed to be
It is understood that, if there is any change of status regarding our participation with the above mentioned
project, the Building and Code Regulation Divisi of St. Lucie County will be advised pursuant to the
filing of a Change of Sub -contractor notice.
GO R. _=OR'SIGNATURE ualifier)
_9�krIr(l
PRINT NAME
COUNTWERTIFICATANWMBER State of Florida, County v ✓(�
11w—foregoing instrument was sig�ned�be�fore me this "1 —Da'
of
20 by _J/Ul rre a'nh- �1
known _21_or has produced a
as
MP'
Signature of Notary Ptwic v— °
Print Name of Notary P blic
"v,,.
AUDREYB.HUMPHREY
v �= EXIIRES Match6,17477
20 92
*:
sr BoededThruWtaryPubrrUoden ft1
Revised I1/16/2016 '�Af��``
SUB- CTO�Sf6 AT _'(Qualifier)'
-Darr)- _IDUn6iI)
PRINT NAME
COUNTII CERTIFICATION 3NUM�Rq
State of Florida, County of
oregoing instrument was signed before me this%- day oof��
20L, by �' r '_ 1 L � l f�JA-'n
Wis person own or has produced a
as identification.
Signature of Notary blic
t) .. '5• 41,,,r�, ae
Print Name of Notary Public
I
uuy
crgl'"r Pik, AUDREY B. HUMPHREY
* *: MY COMMISSION # FF 174772
EXPIRES: March 6, 2019
4f Borded Thru Notary Pubk Underwr ters
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