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HomeMy WebLinkAboutSubcontractor Affidavit�wr yi1 �g+YfdF��fl j6a iD'r��i'G"' ,. PLANNING & DEVELOPMENT SERVICES Elliidit & Co& Compliance Division BUILDING PERMIT SIIB-CONTRACTOR AGREEMENT 5 e, Zii% I C'c X1/ G (Coy9pany Name/Individual Name) the Z %c.T t , -z e� / Sub -contractor for (Type of Trade) For the project located at (Pmjwt Sheet Address or Property fa: agreed to be �4 /! n a Uey e_ LV4e i 6'. C-C i/_" ( Contractor) t 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 (Qoaniier) COUNTY CmrwiCATIUNNUMBER State of Florida, County Tte�/foregaioginstrementwnisignedbeforemetbislS7 gy of ` — � z_aoygcvkk who is personally known-Kor has preduced a , asidentification. a / 'Y_4 UL, - 6 �C G .+�„G�.., STAMP Signature 6f Notary rabge PrmtNome ofNotary Public .c�a�s�, `NotedPu611c�et9oppiadaa 3 KeN Buaka ' • a Mf fAmmission FF 978543 Revised 11/162016 " q Expires o5fa51202tl 4MORSAHOMMT (Qu armr) LaL✓r-rnce f/• Th�h� PJUNTNAME �2 9 4-1-/OZ COUNTY CERTIFICATION NUMBER State of Florida, County af. �.c..14, The foregoing instrument was signed before me tbis_ day of �zo, who is personally known ALor has produced a as ideatifccation. p �dA STAMP \Sigo�atura afNotary Pablic QL,:`10_ 0� 1c.�ae C!a Q PnatName at Notary Pabtic M:j CUABEOGEdn#G©0220TDtober21,202DicjFatnNisieMal04a9I.7019 shim, t®pfd'iBF36 .kbvndiolgs4 AIf*Owb any ��� �)' ..._ _ ___ t_. ' rSF1 �FFla 6�a,�ikAP➢ Now t_ @ 4Wmlg . $tAFAaI�''l81fi4A+,�AaaiyAv�\"e F�1APa�?R Fr�sA�maa6ev1sal FWf.APRmsFu4byAF �$s�9�€aa�asilyUgA(rn?LpipA,ssPA�aa�iAA _ MAW $, ' rrsAFAayi A�FIA . . ��iut3o`A�AF�`A1uPykutrlte .foa 9FUglAff,N 16Rf08A531&aR i7BfiDPB.lR,4 FEE ��RAy Ai' erAA Es�sPA9eAFFybnAaa �c4esbsAPvAa@ u�• Fga°nuaoi�S ija>lu ..+� U . Rhonda LWwW : . tFiILF$®lNS9Fl�FAPj'i+a>3 ..._ . • DOROTHY.ANN SASKIN- s MY GDMMISSION#GG030745 r, s7; ;.. ' EXPIRES: Octob6r 2, 2020AlY - MF�FF3Ff�J�72A' 11 .PAlUi8PG9FG ,10Bon dedThNtJdteryPuhlk.UndeM7ite+s ..; iS91f t913f FYf + PERtNl7# ISSUE DATE PLANNING & DEVELOPMENT SERVICES Building & Code. Compliance Division $IilY,DYNG PERMIT suit-CoNTRAcr0R A(;REEMNT rt Control the HVAC Sub-contfaetorfor Wynne Development Cori). (Type of Trade) (Primary Contractor) For the project located at '(Project Street Address or Property Tax ID 0) 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 Couray'will be advised pursuantto the filing of a Change of Sub -contractor notice. CONTRACTORSI ATUn(QU&Mer� Matthew Lyle Wynne PRINT NAME 08898 $288 COUNTY CERTMCATIONNUMER COUNTYCERTIPICATIONN N\\UAMM State ormorida, CountyOf � .LV e+ \'p, Statf;ofMorida. County of!!�c The foregoin&strnm'entwsssipedbefdremethaCA �11 �" yof TLe:foresao�iaskumentwasaignedbeforemethis_asyof �ee..2g,..e who is persoaaay known —'V/01 has produced a who is personally lmowa —!:,for has produced a ' as///Idd��gJel ication. //& ryn(_ a STAW Signature ofNota. ubhc DOROTHYANN BASKIN MY COMMISSION # GG 030145 6PIRES: October 2, 2020 Bonded Thry Notary Public Underwdlar Remsed 111100i6 as idmWicatiea. ��r-t y/�, ( �l�Vy✓r fJ STAW Sign�ofNotaryFab l' , 0 2oMl y fQaA/ �L� Flint Name of Notary public €�i0d� DOROMANNBASKIN MY COMMISSION # GG 030145 +5 EXPIRES: October 2,2020 .'%;;pq i�$:'' Bonded Thm Notary PublIcUnderwriters ' 36-d WOO/MOOd bLO-1 999L8LKLL dJ03 suip[in8 ouuAM -Woad gL:Zi 96,-60-ZL 14ow op*0m. Luce dklnlbs�,. DOROTHYANN BASKIN MY COMMISSION# GG 030145 wev EXPIRES: Odlober2,2020 Pubbugewdem 0 'i cmty CIE; 6ABrAleie spa DOROTHYANN BASKIN MYCOMMISSIO'N#GG030145 EXPIRES: Octaber2,2020