HomeMy WebLinkAboutSubcontractor agreement, electricalPERMIT# ISSUE DATE
ti PLANNING & DEVELOPMENT SERVICES
= Building & Code Compliance Division
- - BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
uJ __ & m_ POA.J_(�LLhave agreed to be
(Company Name/Individual Name) '''- 111- , To
C the 1 I eCAr i � Sub -contractor for �V 1' l —AkA y\-1 nckn
(Type of Trade) (Primary Contractor)
For the project located at ) ? �e,-J iT' Qir
(Project Street : (Jd •ss 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 St. Lucie County will be advised pursuant to the
filing of a Change of Sub -contractor notice.
CONTR-4CTOR SiCFATI'R lualifier) ,,� �`
.�,IK5�
PR]tiT ti,lifl:
CMG 152 58
COUNTY CERTIFICATION NUMBER
State of Florida, County ofMa Af 1J
The foregoing instrument 1was signed before me this day of
2tilL h►• _ J
who Is personally knownX—or has produced a
�s identific+tiau_
���STAIMP
Nignatu of No a • ublic l
Print Nzn , of Notary public
a-*Y PU'. Nolary Public State ❑l Florida
�r Angela Staples
r iNy Gors;m�s3rnn GG 235102
.i M14�9 Exp.,e5 ❑Fi{J4I2122
Revised I.IW2016
- aalv_l
SUB-C:ON"I RAC'MR SIGNATURE (Qualifier
PRINT %X%IE
P,C,60 rD S 9, q L
COUNTY CERTIFICATION NUMBER
State of Florida, County of mr,�M VJ
The foregoing instrument Has signed before me this ! q day of
60,",�a N za21. P
who is personally known Yor has produced a r—% %-X� l 1 cLe- 4P
ask nti'cation.Z6 �,A�
STAMP
Sig aw ' of dot ►• ubiic I
Print ti c of 1r r► Pubiir
�r a Notary Public Slate C` F1r}rida
a Angela Staples
2
r MY {;r�rnlnlsssan GG 235102
Exr:ras fl'i +pA12022