HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENTF
�=-
ISSUE DATE
the ff 001
(Type of Trade)
For the project located at
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Sub -contractor for
(Project Street Address or
(Primary Contractor)
Or
ID #)
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.
/// �Igi7tif 2_
CONTRACTOR SIGNATURE (Qualifi
T'„l d
PRINT NAME J
COUNTY CERTIFICATION NUMBER
'
State of Florida, County of
//Thhe foregoing instrument was sign before me this day of /�
`JG�,20 �4`, by �� J G-
1
who is personally known _or has produced % C—
a/ss identification. "�t,.
1 1, dun t�7( n�m Z> �/1,SfAMP
ignature o Nota Public
,+UI, r h7 X/OVf; /
Print Name'of o Public
•:.+^:? AUDREYB.HUMPHREY
MY COMMISSION # GO 300817
qn ';;'•s.'o: EXPIRES: March 6, 2023
p e• Revised I l/162016 Bonded nun Notary Public Undenssilem I.
n 'Forne.
SUB -CONTRACTOR SIGNATURE (Qualifier)
PRINT NAME
NA
CO TY CERTIFICATION NUMBER
State of Florida, County of 1 "� Lt4Gl'G
'M m
The foregoing instrument was signed before me this 11L day of
who is personally known _or has produced a �--
as identification.
TAMP
Signature of Nota ublic
Print Name oralotary Pub c /
:d^:4 AUDREY B. HUMPHREY. 1,
• „ MY COMMISSION#GG 300817
;'rl=?s •�= EXPIRES: March 6.2023
'•-.FP''• Bonded Thru Notary Public Undervrti!ers L'