HomeMy WebLinkAboutZeek subcontractor affidavit ComoPERMIT # 120120364 ISSUE DATE t
PLANNING & DEVELOPMEN I SERVICES
Building & Code Compliance DDivision
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
?60 ffAn o—
C_ 0 Er—i D have agreed to be
(Company Narric/Indi-vidual Name)
the +OW ', and, Sub -contractor for St Pierre Construction, Inc
CAIP e of Trade) (Primary Contractor)
For the project located at 15358 Navion Drive Port St Lucie FL 34987
(Project 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.
CONTRACT' SIGNATURE (Qualifier)
Wayne St Pierre
PRINT NAME
28612
COUNTY CERTIFICATION NUMBER
State of Florida, County of J--ACD
The foregoing instrument was signed before me this day of
M(XV_(_) ) .20aJ-,bv
who is personally known —or has produced a tL
as identification.
SUB -CONTRACTOR SIGNATURE (Qualifier)
r Dgew
PRINT7NAME
N 1-1 � A
COUNTY CERTIFICATION NUMBER
State of Florida, County of ja&r, br
The foregoing instrument was signed before me this , J Elay of
201t, by
who is personally known)(_.r has produced a
as identification.
P ZIMMERM I
of Notary Pubte I i Notaryftw
Slate of Florida
lor da
Commi!
3sion # GG 14163,
:z MY commission Expires
September 09, 20-2-1
Revised I 11612016
�AN
DANIELLE P. Zi MM E11Public
State of Florida -Notary , b Iii c'
::.15.__=-Comrnis%T6#I#�GG
141634
My Commission Expires
September 09 2021