HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENT1
# I I ISSUE DATE
,w PLANNING & DEVELOPMENT SERVICES
6
'9iriiafing & Code Compliance DIvi9id ANNED
1NOW
BY
BUILDING PERMIT Lucie (���{�„
ui SUB -CONTRACTOR AGREEMENT � u`�.�'
Womm POZIS
the.1II V)U
0ype of Trade)
For thelbroiect located at
Name)
a W a
', ��have, a eed to be
Sub -contractor for a,J zzr4 ft 15
(Primary Contractor)
.-o#iv,sro,..! ere e__
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, I e Building and Code Regulation Division of St. Lucie County will be advised pursuant to the
filing o I a Change of Sub -contractor notice.
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PRINT NA ` E
PRINT NAME
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CQiINTY . ,RTWT(_ATIQN NfWRF.R
(`QLlNTY CERTIFiCATIQN NLWHRR
of Flo �a, County of �jl
I
1day
G��State
State of Florida, County of _
The foregoin instruments signed
_before of
�c�/ , me thi ✓
3tl �d, by
The foregoing instrument was signed• before me this / day of
l O, by
I
who is perso Pally Imown ✓s or has produced a ..
who is personally Imown✓�Or has produced a.
as identification.
as ide tification.
STAMP
Si_gfi pf _tdij+l'plilit
STAMP
si..' _tui'L+tffNniitutZc ra ;1i1818ii8111
NOTARY PUBLIC
Josatld(aA,dngraham .
STATE OF FLORIDA
Print Name of otary
STATE OF FLORIDA
Print Name of Notary Public • GG032559
Explres3/9/2020
. C,Qm t* GG032559
E e EX*J s 319/2020
Revised I1/10616
17VII-roffl
St.
A
DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
J"0VI P TI �_ LU
the 1`(Company Name/Individual Name)
1E MICE
(Type of Trade)
For th ,, project located at
Itisu
proje(
filing
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
%,/A`.111, 110K elAJO �� JOha�vJe agreed to be
Sub -contractor forlZ(�N
(Primary Contractor)
'ob 74� __-
- c;�D& 5,W ed
(Project Street Address or Property Tax ID #)
erstood that, if there is any change of status regarding our participation with the above mentioned
the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the
a Change of Sub -contractor notice. A
L�TTRSURE (Qualifier)
�-
W&CLL a) NaA4._
PRINT N dkME i
0 DP )45 �Lq
COUNTYCERTIFICATION NUMBER
I
State of F �I rida, County of Lao jL G�
The reg�p�nngg instrument was signed beeforJe me tth�iss 1 day of
20S by
who is personally known 7i or has produced a
as identiry !Ia om .,
STAMP
Notary Public
J9Sandr8A.rrW8iVM
NOTARV PUBUC
PublicWIATEOFR.OMDA
IbOires 319=220
Revised 1
SUB -CONTRACTOR SIGNATURE (Qualifier)
XK-MlUf, CAJ60- fIA-A)iI
PRINT NAME
�5(f 0003 07R
COUNTY CERTIFICATION NUMBER
State of Florida, County of`�(�/ e� / )
The foregoing instrument was signed before me this �` day of
who is personally known or has produced a
as idea ' tion.
STAMP
Signs a of Notary Public
.k9saatdra /C'Irl9talea�n
Print Name of Notary -NOTARY PUBLIC
STATE 0# FLORIDA
QMV4 GGW,09
E*res 3/9=0