HomeMy WebLinkAboutsub affadavitt for fruth permit 2101.0052, 2.1.210001PERMIT # S L C a l a i ® o. s--� ISSUE DATE j_ i Q ®a I
PLANNING & DEVELOPMENT SERVICES
V . _ 'I J': Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
f'\.,O i Ca have agreed to be
(Company Name/Individual Name) ,J
the V ( S d rn �� Sub -contractor for " Cknt.0 m_"r� e ,n
(Type of Trade) (Primary Contractor) k p ++
For the project located at
ect 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 St. Lucie County will be advised pursuant to the
filing of a Change of Sub -contractor notice.
CONY TOR SIGNATURE (Qualifier) S B-CONY T SI RE u ' rer)
Lclev "n =ame ,5 ka +
PRINT NAME
a -M � I
COUNTY CERTIFICATION NUMBER
State of Florida, County of D q ty
The foregoing instrument was signed before me this r .. day of
, 20 2) , by i ()
l) kn�.P
who is personaown �as produced a
a tification.
f Y\ lN►�U STAMP
Sig ure of NotAy Public
/V -
Print Name of No iyPuAic
RIEE
tate of FWide
ichmond
n GG 2g4491
/2023
Revised 11/16/2016
PRINT NAME
3i )Z�<
COUNTY CERTIFICATION NUMBER
State of Florida, County of r r U e
The foregoing instrument was signed before me this I day of
, 20-')J, by aril _ rx ,L-"] S
who is personally known or has produced a
dassiidentifiication.
11 I1Y 111V C�%./,�i�.7� h ' STAMP
gnattire TNotary P
Print Nat re of Notary Public
MARY ELIZABETH ROTT
Commission # GG 918519
Expires February 1, 2024
Bonded ThruTroy Fain insurance 8&385.70i9