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HomeMy WebLinkAboutSub-Contractor Agreement PERMIT# ISSUE DATE _,,_r , j_ e _ PLANNING & DEVELOPMENT SERVICES Building & Code Compliance Division COUNTY BUH DING PERMIT SUB-CONTRACTOR AGREEMENT `—O W G �_' L E QV VZ- C. Z 0 C', have agreed to be (Company name/individual Name) the Electric Sub-contractor for NA Lp, �► 4D�S� ��(�C. (Type of Trade) (Prise Contractor) For the project located at 9960 S Ocean Blvd. #1101, Jensen Beach, FL 34957 (Project Street Address or Property Tax TD#) 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. 2e' — C TRACTOR SIGNATURE(Quniifler) -v CONTRACTOR SIGNATURE(Qonlirter) Katherine LaDeene Dodson ,p �40j ter. 44�? _-_- 4:f_�' PRINT NAME PRINT NAME CBC 1250637 � Q 9 q 1 COUNTY CURTMCATiON NUMBER COUNTY CS RT►FICATION NUMBER State of Florida,County of St W LIC State of Florida,County of3k t VL6l�l The foregoing instrument was signed before me this 3 ``day of The foregoing instrument was slgued before Tin this_dna•of �l P HCkrCh 2o�U {�by �L il��11C LQVCSfl�. 0(60A Y) l .2ozi hycm i �L s Y `/ who is personally(mown X or has produced a who is personally known�Pr has produced n as ideutlricatio(�n.y� as Id Ificat u. y AA111 5TANA' Signnmre orNolary Public Slgnnturc 0 019•y 1'1dll c Print Noted_nfNdury Public 6611 Nwine of Nnrxry Public ,W NOWry Putsle Slam of Flom" y. +? Sabrina M Arrington Reviscd 11/16/2016 My Commiss GG 9M270 �{__ �yb w ion Expires W2712023