HomeMy WebLinkAboutSUB CONTRACTOR AGREEMENTPERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
.lj(,CIA5
ne/Individual Name)
the
For the project located at
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
SCANNED
BY
St. Lucie County
have agreed to be
Sub -contractor for
�imary_Coptractor�
S+
(Project Street Address or
191
70 /-01
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.
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County ofaW A
The foregoing instrument L
was signed before me this 1/ day of
Kb/ , 20A bye i�' /11l �i)'110.1y
who is personally know or has produced a'L_ LV
asidentification.
D STAMP
i nature of Notary Pdblic
Print Ni a of Notarya li , kf
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<SUB -CONTRACTOR SIGNATURE (Qualifier)
PRINT NAME
aez t' .))
COUNTY CERTIFICATION NUMBER
State of Florida, County of
The foregoing instrument was Signed before me this day of
20_, by
who is personally known or has produced a
as identification.
STAMP
Signature of Notary Public
Print Name of Notary Public
PERMIT #
t
.S
ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
(Company Name/Individual Name)
the �i�,,~ ;, Sub -contractor for
(Type of e)
For the project located at
(Project Street Address or Property Tax ID #)
SCANNED
BY
St. Lucie Countv
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.
C rOR SIGNATURE (Qualifier)
uCAY, ICI%,I ('0 -ts-
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of -iir o.
The foregoing instrument was signed �bbeefore me this A day of
ftJDY �-- 20D by y'
who is personally known _or has produced aX�,
&I"N19
j:P:M'f'S'd•: IN "'LRAMMING
Revised 11/162016 j ;eo p•,.2 YV
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SUB- NNTTPACCTTOR SIGNATURE (Qualifier)
1, ��,. a
PRI�r
COUNTY CERTIFICATION NUMBER
State of Florida, County of
The foregoing instrument was signed before me this day of
20_, by
who is personally known _or has produced a
as identification.
STAMP
Signature of Notary Public
Print Name of Notary Public