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PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
gL 'A (A, ,,,� i ,,� „� ^ � oti P l �- N � have agreed to be
(Company Name/Individual Name)
the 9C'(t 4gA2 Sub -contractor for ?o b L P t� I- t
(Type of Trade) (Primary Contractor
For the project located at �1{3 1 Lnl l r4� q_ i�or�! 1 y �c r 34 �?&-Z_
(Project Street Address or Property Tax 1D #)
I
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 -contractor notice.
CONTR4CTOR SIGNATURE (Qualifier)
'.k
PRINT NAME
COUNTY CERTIFICATION NUMBER
SUB -CONTRACTOR SIGNATURE (Qualifier)
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of State of Florida, County o " 0-
The foregoing instrument was signed
before me this day of The foregoing instrument was signed before met ' ay of
z�by A_1.��y��p ��{ ,Zt_,by
who lYpersonally known or has produced a who is personally known _or has produced a
a identification. a identification.
STAMP n STAMP
�gn re of Notary Public ign Lure of Notary Public
Print Name of Notary Public
LASHAHNAINGRAM-RAHMING
=¢ *, MY COMMISSION # GG 275060
=ems o�= EXPIRES: December'20, 2022
.,. QS
'.Fof F ;°,' Bonded ThN Notary Public Underwriters
Revised 1ow
Print NgMk,91 atW_-j_+ttblie
_ions:?go(c, LASHMNAIWGRA,4-RAlih1lK1G
MY COMMISSION # GG 275060
yro: EXPIRES: December'20, 2022
FOF (; °•'' Bonded Thru Notary Public Underwriters