HomeMy WebLinkAboutBUILDING PERMIT SUB CONTRACTOR AGREEMENTJ
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ISSUE DATE
PERMIT # I I '&I Q b ;1&;
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
(Company Name/Individual Name)
(Type of Trade)
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
WA NN ED
By
have agreed to be
Sub -contractor foryfmr' &n caes co -
(Primary Contractor)
the project located at ffryk4 rV ? r i"
(Project Street Address or Property Tax ID #)
understood that, if there is any change of status regarding our participation with the above mentioned
ect, the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the
of a Change of Sub -contractor notice.
SIGNATURE (Qualifier)
of Florida, County of
oregoing instrument was signed before me this day of
Z0! , by
Is personally known _or has produced a
Name
N'rRACTOR SIGNATURE (Qualifier)
PRINT NAME
2� 1 c0-4
COUNTY CERTIFICATION NUMBER
Sta1 aTiorida, County of 5o k e
The foregoing instrument was signed before me this30 day of
u--k .20jJliV Q^fAr 1-9s (fie .u-Ael e;
who is person NaME9 olur has produced a
ion. as identilicutlun.
'cz
STAMP STAMP
Notary Public Skgan re Rota 'e
11/16/2016
DAVID JURKIEWICZ
MY COMMISSION # FF913i3909
EXPIRES June 05. 2o20