HomeMy WebLinkAbout1802-0573 RECEIVED
APR 1 l _
PERMIT# 11, `� 05 7 3 ISSUE DATE
permitting Department G»� V
st i uctu-County -
_r ' PLANNING & DEVELOPMENT SERVICES / °9
` i j I Building & Code Compliance Division -,t-'
avitl
+ ;. 147/ D
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
'art5 c./ ele-C-1-- 7cJ Se.,Vf have agreed to be
(Company Name/Individual Name)
the -El e c /././c c l Sub-con tractor for J a k Ptc Liia 4. c'_
(Type of Trade) (Primary(Primary Contractor)
For the project located at /3 z) �
if/ ;� _ p .; D
(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.;t. Lucie County will be advised pursuant to the
filing of a Change of Sub-contractor notice.
ditr-NTRAC` OR A''URE{Qualifier SU -CONTRACT• SIGNATURE(Qualifier)
"NP
X11 '�
PRINT NAME PRINT NAME
COUNTY CERTIFICATION N EMBER COUNTY CERTIFICATION NUMBER
State of Florida,County of 1/41V rtiCh CI
I State of Florida,County of tifilictA,
e foregoi4_instrument was signed before me} this l day
of The foregoing instrument was signed before me this day of
it / ,20 by v l�'�l v II.IU 1 1 1 l C l�(l l 1 u` ,20 by ( C/1
p
who is personally known_or has produced a '"rt^Y_____ who is personally known�or has produced a pep
as i a eutification. - as identifica,'on.
1011111010
1 L 1a i A j M�% 1-11 , STAMP .'_- STAMP
Tr ature of Notary-ft-ilk iffir/ 'of Notary Public
Print Name of Notary Public Print Name of Notary Pubh
Jose Tip}a
40. Mie tone Brownstein r a;,�0 State of Florida
NOTARY PUBLIC N Q My Commission Expires 04/13/2018
�icL " STATE OF FLORIDA o�
.wr..,,,,= 4 aQ Commission No.FF 149949
Can't*FFV3837
Revised 11/16/2016 " if Expires 4/28/2019