HomeMy WebLinkAboutSubcontractor Agreement PERMIT# 1�di_ �L] a� ISSUE DATE
- PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
J N e' IJ have agreed to be
(Company Name/Individual Name)
the E l 2 C_ Sub-contractor for !� �(' ► Q
(Type of Trade) �A (Primary Contractor)
For the project located at "1 C� •��S 31
(Project Street Address or Prop&ty 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 SIGNATU�RE(Qualifier)
SUB-CONTRACTOR SIGNATURE(Qualifier)
PRINT NAME PRINT NAME
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER
State of Florida,County of e,:� -L j c �� State of Florida,County of
The foregoing instrument was signed before me this day of The foregoing instrument was signed before me this day of
Se\^n ,20 til,by D G IN h a rte G C I'% .20_,by
who is personally known_or has produced a ` L who is personally known_or has produced a
as identification. as identification.
^�••, DEANNAMPM50 STAMP
Signature of Notary Pu !c ' com?60SSIO GGA 0 23 Signature of Notary Public
' = EXPIRES:December 16.2020
�' •f r oP� Banded Thtu Notary Pubrta Undenrtiters
to r�o< _ .. ...._.• ... _
Print Name of Notary Public Print Name of Notary Public
Revised 11/16/2016