HomeMy WebLinkAboutSUBCONTRACTOR AGREEMENTSPERMIT# I I ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
-- — — -- BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT SCANNED
BY
- — St. Lucie County
/ have agreed to be
( omp Ndi jdualt'Name)
the 1a n],, 2), Sub -contractor for
(Trade) (Primary Contractor)
For the project located at
or Property Tax ID
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
Sub -contractor
.ualifie
, ,NAT , -
PRINT NAME PRINT NAME
COUNTY CERTIFICATION NUMBER COUN Y CERTIFICATION NUMBER
State of Florida, County of 'S'I• 40 �- State of Florida, County of J4. Zkt&i C. ^r�
�Tke foregoing instrument was signed before memthis day ofy� The foregoing instrumentwassigned before mnelthil 11'- day of
—]�,20VJ by VV e7L� v�- ,20 IJ' by fob my N *I LL.
U
who is personally known r has produced a who is personally known "I'mr has produced a
as identification.
tSTAMP
Signature of N t ry Public
Print Name of NotAry Public
yCo�BSiONt *3
M OP1RES:t ;ate
Revised 11/162016
AU�pNREY
MY COMMISSION S 0G 3p0817
E%PIRES: March 6, 2D23
....ee 1lndensdh
as identification.
''��" J / STAMP
Signature ofNota 'Public
�5' �) V- "bVot:;y
Print Name of Nota yPublic
No Y B. HUMPHR�
COMMISSION 0 s02 00 1
ti>V 7
1�p+.r••��;
E%PIRES: M � gcUndeN+Rters
s �,tuNotarY
;;undcd
the
FRE:i
ISSUE DATE
(Type of Trade)
For the project located at
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Sub -contractor for
�303 5 116�01. n
(Project Stre=ressor,Property
(Primary Contractor)
SCANNED
BY
St. Lucie County
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 Division of St. Lucie County will be advised pursuant to the
filing of a Change of Sub -contractor notice.
0
QCQ� _RACf1J SIGP
MOD ON)'" P19L�-
PRINT NAME
)
JY I'M
COUNTY CERTIFICATION NUMBER
State of Florida, County of �� • �`-�r-G/ e-
�The foregoing instrument was signed before me this day of
y�
20 by?�
who is personally knower has produced a
as identification.
STAMP
Signature of N ty
ry Public
Print Name of NotAry Public
REYB.HUMPt"-:q51
_ • .,.yM.: MY COpRASS10N f
.rxnle
pgy 1RE
Revised II/I62016 r--+,;, '"�
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w coMMIS510N µGG 3 202.23
EXPIRES. Mares fi, t
__. andelJndeMT
Q1,KI�=CONTRA OR SIGNATUR�Q fiery
dog 2)Nt
PRINT NAME
Z
COUNIrY CERTIFICATION (NUMBER
�
State of Florida, County of Sq. .ral e-
he Foregoing instrument was signed before mne�tb 1r�'f day of
who is personally known —Or has produced a
as identification.
STAMP
Signatore ofNota Public
Print Name of Notafy. ublic
EilyDyR1REY
ESS S:IM6NaMOPG
HcfiR3nE0Y
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