HomeMy WebLinkAboutSUB CONTRACTOR AGREEMENT3
PERMIT# 190M300 ISSUE'DATE 1,02/1512019
----- •• 'CANNING &DEVELOPMENT SERVICES
Building'& Code Coimplimnce Division,
•
• e SCANNED
BUILDING PERMIT' _ BY
SUB -CONTRACTOR AGREEMENT St. Lucie County
For the project located at 913 Jackkn Way, Fort Pierce, FL`34949
(Project Street .Address orProperty Tax ID� -
Itis understood that, if thereis any change ofatatus regarding our participation with the above mentioned:
project, the Building and Cade Regulation Divson.of St.. Lucie County will be°advised_pufsuant to the
filing of a Change of Sub -contractor notice.
CONTAACTORSIGNATURE (QuaBBer) -
T arein Goldm
PRiNT,NAME -
CV:C 5065 - _
COUNTY CERTIFICATION NUMBER. 1�
l.
State of;Rlorida, County.of iaYYI�- n�
The foregoing lnstrumeatwas signed,Eefore me thisW day.of
1Febr�� 20 v' by
trho Is personally hnowrivor fias pioduced a
m identilleation..
.;[IfL:. _ .. .. .STAMP
Slg�re ofNataryYo6lie _ ." -
��ie�e� RQ
Print Naive of Notary Public
u*rr4.. NotoryPubGe state of Fiodea
`F JoVetteRe '
.._.-..._•. .,.�__,_ ._ _ MYC0Mnii3s(on GG 288924._,.
'!p Erpires 61108 023
Revised a 1116Y1016 -
SUBCONTRACT RSIGNATURE(Qualifier) -
.. Rti{rJfiYl . IJi44 at
PRBVT NAME ...
COUNTY CERTIFICATION NUMBER t�
State, of Florida, County of•Mtiam1-.
Theforegoing instrument was signed beforeme this.K\ day'of.
Fcbruar " 26.&by RUu Oer1ba
'who is personally rmowu± or has produced -a
asflendfl ation.
.... .. 'STAMP
%Sdum of NotaryPublie' -
SolWAP, -IL.
Print Name of Notary Public