HomeMy WebLinkAboutSUB CONTRACTOR AGREEMENT 1PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division SC MM,,,
BUEUDING PERMIT St. L
SUB -CONTRACTOR AGREEMENT ucie conr1 ,
(Company
the
3be6 ';w 7
3zl0 3Zt%
For the project located
Sub -contractor for
22 (Primary Contractor)
�(
3 zt5 S. L,di
or Property Tax ID #)
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 Su ntr or notice.
4
CO CTOR SIGNATURE (Qua er)
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County ofIY,,d'Ia Q a "lor
The foregoing Instrument was signed before me this Lbduy of
:d . by r n
who lsp Uy lmowu ar luspmduceda
as identification.
qI
STAMP
tareofNotary c
,,:S1eh . K SSo,-Ms-A
Print Name of Notary Public
JOLENE K. SOUTHWICK
t YI'1 MY COMMISSION #FF079740
4. °r
Revised 1111612016
k@a;n� EXPIRES December 29, 2017
*...........
(407) 39e-0153 FloridallotarySemlw.com
COUNTY CERTIFICATION NUMBER
PLI .
5go(q?
State of Florida, County of
The foregoing instrument wan signed before me this Id day of
Miq // 2ol2by G�A�ith%�d%��C�
who Is personally (mown Z—or has produced a
aside 8frcation. GIENNRGIT"
i MY COMMISSION # FF 03168
EXPIRES: October 1, 2019
°^. 4,ngmgoirn kEpdNohrySrneVAMP
S ture of Notary Public
l��tnn Roffman.
Print Name of Notary Public