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HomeMy WebLinkAboutsubcontractoraffidavitblaisPERMIT # I SL(L V` 0'5 _ m _ I ISSUE DATE PLANNING & DEVELOPMENT SERVICES Building & Code Compliance Division BUILDING PERMIT SUB -CONTRACTOR AGREEMENT ?[ 'Pal -K �' $ R 5 � �61� have agreed to be (Company Name/Izldividua -Name) the Cfec_(f&C.'/ Sub -contractor for ` 1 e �e� /� t e 42 PC7_ (Type of Trade) (Primary Contractor) For the project located at S'�a�5 ��/,� Irk evc C �t"rtorr �ele (Project Street Address or Property T ID 9) d yf,;-1 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. - �f CONTRACTOR IGNAT E ( alifier) H 1C. k1''lR r 04 A� (,izri i PRINT NAME COUNTY CERTIFICATION NUMBER State of Florida, County ofinn lz1NJ L.I The foregoing instrument was signed before me this 19 day of Ane 20-50Y "1 , J McQeat who is personally known _or has produced a s i iification. STAMP Signature of Notary Public ��Sgbii �Yl��apfQ� a4Sa° w\i� A Ain.01.0.cof 4 Y.'1 •�AR� °• b4 • � JMY COMM. Expires Apr 14, 2023 GG 323282 Revised 11115/2.016 s�®i+ �' O F *n *ST TOR SIGNATURE fier(Quali) m h -Q j'/`✓le- PRINT NAN E 0 *0 COUNTY CERTIFICATION NUMBER State of Florida, County ofz]EN� Pr'W_ QS:-. The foregoing instrument was signed before me �this of of 2 by 3-2i 4� L ��1 V [a who is personally knownZor has produced a, a STAMP of Notary Pub ' SppY q Barbara M. Resin f°n NOTARY PUBLIC ue of Votary Public °o — STATE OF FLORIDA f $ Comm* GG346694 Expires 6/19/2023