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HomeMy WebLinkAboutSUB CONTRACTOR AGREEMENTIPERMIT;Y I I ISSUE DATE PLANNING & DEVELOPMENT SERVICES 1 J' Building & Code Compliance Division • e- -- BUILDING PERMIT SUB -CONTRACTOR AGREEMENT (Compan3, NalneAndividual the (Typeol'Tradc) For the project located SCANNED BY St. Lucie Counttr have agreed to be _ Sub -contractor for 76� S1kTSo n� — /11dt3 1rti �1 i�'R r (Primary Contractor) _ �. neecr, �;�,j: 17CA a.t�G,f F� Address or Pro1Nnv Taz D NI 3Y9S 7 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 Chang of Sub -contractor notice. C NATURE (Qua iReel To1� tt -56 n PRINT NA. COUNTY CERTIFICATION waiBER Stow or Florida, County orjS4_._9u_c, e rC -rhe foregoing ins<rno¢nt xas sianetl befom we this n2 day of .QeCC vas 6 Y-;20j J by T�j who Is Pe Wuy known X_or has produced a rry(as Identification. sigh— tom or� aNotary Public �dit,G.�c Ida �4 — — _ PnotjVamc of Notary Pobllt �rxvn EDWARD KOTCH a,�°s.; NotaryPublic-State of Florida Commisslon F GG 113882 " My Comm.Eapiresen8,2021 Rev' L'' emdedWrx+pbNatloulNwxykm s4.i0 h PRINT NAME d3 57 COUNTY CERTIFICATION NUMBER SlateofFToridu,C:oualyor5alys.�- bUGf:e_ The faregaiog [aswmcat was stgo bafore me this 7 day of wbo B Pc -Holly kaarvo _or hn Produced a D L itleatN lion. SFANIP si tareofNotary Public Print Name of Notary Public ,+*•. WIWAMKAO8IN f ; MMlyPudlc-Stat:aFlA.da '• Commisslbne GG 132165 '.� MyComm.Erpim8eDlmit '%P2•"• amdMDsou�Wtanals'maryNas the LPERMIT# ISSUE DATE PLANNING & DEVELOPMENT SERVICES Building & Code Compliance Division BUILDING PERMIT SUB -CONTRACTOR AGREEMENT (Company Name/Individual Name) Och-y' 61 r" C Sub -contractor for (Type of Trade) For the project located at (Project Street or Property Tax ID have agreed to be —To v�s t�o r\ (Primary Contractor) ?1 �ll (M t, A- QOk� /Q on o L 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. CO RAAC—TOR SIGNATURE (Qualifier) SUB O CTOR SIGNATL� \ (Qualifier) — 1 �i� sac&s. Jam' O � dJ \ �t CAL PRINT NAME PRINT NAME COUNTY CERTIFICATION NUMBER State of Florida, County of S}• Lie-- The foregoing instrument was signed before me this �21 day of _VPC'cVh ,20-0by C n [t f�4T56f7 who is personally known Xor has produced a as identification. ( STAMP Signature of Notary Public Print Name of Notary Public ,•••'.pv'r'y'•• EDWARDKOTCH r8 z Notary Public - State of Florida i•: �•; Commission f GG 113882 My Comm. Expires Oct8,2021 ' 11 ,. Bonded lhmughNaBonalNcuryAsm Revised 11/16/2016 �lo�• COUNTY CERTIFICATION NUMBER R 3`1�rS� State of Florida, County K The foregoing instrument was signed before me this,y day of rh r r20A by iz4�011 pfW tAeX who is personally known -Kor has produced a as identification. ^^ bignature of Notary Public kleick— Print Name of Notary Public •o�ii+�>o'"•: EDWARDKOTCH �� Notary Public -State of Florida s • - CommissionAGG 113882 %+�. Fr' MyComI. ErpiresOct8,2021 ''.Ot F,•••' bondedlhrou ghNatioulNalaryAsyi, STAMP