HomeMy WebLinkAboutELECTRIC SUBPERMIT # ISSUE DATE
CUCINT'Y
F
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'0 R'',1
,D
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
ELECTRIC CONNECTION/RANDY SJAARDEMA have agreed to be
(Company Name/Individual Name)
the ELECTRICAL Sub -contractor for HOMECRETE HOMES INC
(Type of Trade) (Primary Contractor)
For the project located at TBD CARLTON RD / 3228-600-0001 000-8
(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.
C TRACTOR SIGNATURE (Qualifier)
PRINT NAME
CONY CERTIFICATIO NUMBER
State of Florida, County of
The foregoing instrument was signLd before me this oy of
rlwlrt 1 ZoZl by
Q�-1 Ce1 JC_
who is personally known lzor has produced a ,
as identification.
Signature of Notary Public
Print Name of Notary Public
_µ+Pry Notary Public State of Florida
�^ Melissa D Showman
�4 My Commission GG 294495
3Y'j Expires 01/24/2023
Revised 11/16/2016
--- �SIGNAUTURE(Qualifier)
Randy Sjaardema
PRINT NAME
21055
COUNff CERTIFICATION NUMBER
State of Florida, County of - LUCIE
The foregoing instrument was signed before me this 8 day of
APRIL 20_, by Randy Sjaardema
..... .........
who is personally known _or has produced a p/k
as idcnlifiraiirut.
STAMP CD
SignatureofNotarl Public
Shyan T Bromelow
Print Namc of Notary Public
SITYAN T BROMEI-OW 1
'+otary Public State of londa
Commission # GG 26371
My Comm Expires Oct
.� Bonded through National Notary Assn,
STAMP