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HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENTPERMIT# ISSUE DATE Building & Code Compliance Division BIII,DDIGPERNITa SCANNED SUB-COAMIACTORAGREEMEINT BY St. Lucie County have agreed to be rite U(Y) l 'r) Sub -contractor for �tY(lV1/n ( 51 YlX�1JU/l �tai (T e ofTradeyJ (Pnmary Contractor) For the project located at L7 S q�egI� A,� j. 40y -fie ffz)pyt f,,Oi k Ft, 9, (Protect Street Address or PrenertvTnv rn in r 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 CQUN CERTIFICATION NUMBER State of Florida, County of 1.i The foregoing lostrumonhvas sip�edb1,e,fore me this!_) day of _ 20 bl• 1/�rrLPNI �l6NLJ who is sonolklmow orhasproduceda as identieption. STAMP 5ignat ofFlota _ Public Print a n Comm slon#GG 32RT79 N� o ExpltesApol29,2023 �,,,,o %-4W pptaolpnnotWssdsw Revised 11/162016 SUB- IS MICCORSIGNATURE(Qaollfier) PRIh7NAME tto COUNTY CERTIFICATION (v-Fi ER State ofFlurida, Counh- of(1 The foregoing instrumentays s'i'.mahefa]mm''SS1ethis Ned yof ��20� by DIXVtO Fit.tS sr. who is personaay Imosrn)Lor has produced a Idenu lion. C1 STAMP 51gn mreo Notary Public �O1PRYr. ,(p . Doreen Langford ter, NOTARY PUBLIC PsntNamc ofiVom�� I. STATE OF FLORIDA d = Comm# GG043591 'pNOE W Expires 12/8/2020 A PERMIT# I I ISSUE DATE PLANNING & DEVELOPMENT SERVICES Building & Code Compliance Division JC,G_ _y- (Company Name/tndividual N the (Type of Trade) BUILDING PERMTI' SUBCONTRACTOR AGREEMENT have agreed to be Sub -contractor for FVV1VV , 0 i nL (Primary Contractor) For the project located at I ON 5• OC&A lbl? . A r- r (Project Sheet 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. CONTRACTOR SIGNATURE (Qualifier) - SUH-CONTRACrOR SI ATURE (Qualifier) Z%Ytl141 )P /i o PRINT NAME G/rG �-sl COUNTY CERTIFICATIONNiA�ERa��l State. of Florida, County of G/01— i The foregoing irttrumentwas signed before me this�day of -)1� zofdby who is onafiy Imo or has produced a as identification. J1-Al STAMP Sio atureo NotaryPublic J41244 A -In", PrintName ofNomryPabfie Revised 11/16/2016 .Joh,� G�tzol�lo PRINT NAME COUNTY CERTIFICATION NUMBER State of Florida, County of r �Cf _ The foregoiug instrument�iwas signed before me this 1 day of vl 20l i. by 1114 il—f �LiyAtJ.+s who is p na lm _or has produced a as identification. STAMP tore of NotaryPubfie J,tnna 61*W Print Name ofNomryPublic