HomeMy WebLinkAboutSubcontractor Agreement PERMIT# I rI O I -D ISSUE DATE _l p_ rl
PLANNING& DEVELOPMENT SERVICES
' I_ Building & Code Compliance Division
D �
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
I r1'e in c- have agreed to be
(Company Namellndividual Name)
the W h, c1 c(C. Sub-contractor for duS TOW y S I e fM
(Type of Trade) (Primary Contractor)
For the project located at ,`j)211 s Uy�Pecr✓,y i��.av PA) 3401' boo-000 OGb�1
(Project 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.
CONTRACTOR SI ;NATURE(Qualifier) SUB-C NTRACTOR SIGNATURE(Qualifier)
CUrtls C'�7tlmrhonj• Pd , /'1 h -e
PRINT NAME S TA T c Cn C'0 5(a 10 PRINT NAME
'x'76
COUNTY CERTIFICATION NUMBER COUNTI'CERTIFICATION NUMBER
State of Florida,County of CTI-00 State of Florida,County of
The foregoing instrument was signed before me this i day of Th regoing instrument was signed before me this day of
SRrS zo17by 0urT+s SR+v`mons. 2 1,by_
who is personally known Zor has produced awl iS personalh +own or has produced a
as identification. as identification.
L7 i^e z e6w
STAMPAiN'IP
Signature or Notary Puhf c Sigr.rture of NW'Ic
fruiter o �S � D iJ- Yl 7e
Print Name of Notary P lie Print Name of Nota r Public
CHRISTINE B.ENGLISH
* MY COMMISSION#EE 859284
EXPIRES;April4,2017 �;��;dys,, AUDREY B.HU
f"reoF F�pw`�' Bonded Thry Budget Ndary Sery tes =�°'' �' MY COMP�IISSION ff FF 174772
fE
EXPIRES:March 6,2019
Revised 11/16/2016
',apt Igo, Bonded Th.Notary Pubr'c Underwrters