HomeMy WebLinkAboutSUB CONTRACTOR AGREMMENTPERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT SCANNED
BY
St. Lucie County
TW %M Q\W
(Company Name/Individual Name)
the yypA w ru Sub -contractor for
(Type of Trade)
For the project located at
have agreed to be
W - i ovr5, (Y),
(Primafy Contractor)
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Street Address 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
filing of a Change of Sub -contractor notice.
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CONTRACTOR SIGNATURE (Qualifier)
PRINT NAME
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COUNTY CERTIFICATION NUMBER
SUB -CONTRACTOR SIGNATURE (Qualifier)
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PRINT NAME
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�PlIl AEG) *:ily1N fN:V 0 UlJRII lYP7
State of Florida, County ofyj State of Florida, County of4 ,,�(
The foregoing instrument was signed before me this day of The foregoing, instrument was signed before me this � day of
}eAt,& 20a, by I !aDu g 'Do Waxy �GXTS(�MY]L� , 2Q,3-, by brAl ts, -" Q AM M M E>
who is personally known/.,jar has produced a who is personally knknown,//—or has produced a
as identification. as identification.
STAMP STAMP
Signature of�Nootta'�nryFuublicc,(/'Signature of Notary Public
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Print Name of Notary Public —Print Name oFNotary Public A
CHANTALMONTGOMERY ,.••;;';;my, CHANTALMONTGOMFR.Y
._- Commission # FF 92:.'S Commission # FF 92e,
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ExpiresOctc.F_,
5,:':•: Expires October 6,2::::
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Revised 11/162016