HomeMy WebLinkAboutElectric Sub AffidavitPERMIT# I 2 00'? — e)(,) 6, I ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Gu i-( JeIe- ` J
c /mil CR / SG✓ 1/i ce S , L G have agreed to be
(Corn any Name/Individual Name)
the C le C TP, ICA Sub -contractor for Hie, /C /� 2 $ -c oP t
(Type of Trade) (Primary Contractor)
For the project located at 1007 �-4 s y 5T l + e f t C, 1`L
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
)�'7/C;,Z46-t- �2CED
PRINT NAME
notice.
COUNTY CERTIFICATION NUMBER
State of Florida, County of l 11 '> l tan
The foregoing instrument was signed before me this � day of
UG7" 20ZU, by.. /edre
1 R E / ;C767 6�
who is personally known _or has produced a
as identific o .
Signatur Notai lie
lft, OWe
Print Name of Notary Public
.. RO6
Revised 11/1
SUB7-CCO CT)OR GNATURE (Qualifier)
PRINT NAME
COUNTY CERTIFICATION NUMBE7
State of Florida, County of Z n C1 G n
The fo�rergoing instrument was signed before me this [day of
U/ 2010, by b&? n / 2 / S
who is personally known 7/ or has produced a
asiT)i
STAMP )F
gk(na4we'of NAPublic
,0&h�h 1klk
Print Name of Notary Public
Notary P.
Stale of Ftpioa
Elizabeth White
00"
W Commission GG 2a7955
Ef,j ExPlres Ot/022023
K
STAMP
`Ji9%/id f125ed��urt�
/007 IFAsy 57-. f; P,eIc4-7,F4-
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