HomeMy WebLinkAboutElectric sub form signed 4-26-21 1PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
4e's Weebic, Ck tS. !F-L i n L have agreed to be
(Company NameftMividud Nam)
the Sub-Wntmetor for Diversified Professional Services Corp.
(Type of Trade) (Primary contractor)
For the project bated at 27101 akeedmbee Road, Ft. Pierce, Florida (3114-111-0001-.000/7)
(Project Sheet Addmu or Pinperty Tax ID #)
It is understood that, if there is any charige of status reWding our participation with. the abcave mentioned
project, the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the
filing of a Change of Sub- �wntw;torno
CONTRACTOK SIGN&TUR& (Qua!Gr)
Donald, R. Polanis
PIUNTNAME
CGCO61303
COUNW CERTWWATION NUMBER
State of 147orida, County of Pasco
The foregoin lastrument w= -kigued -before me thi,day of
who is personally kuo$or has Produced g
COUNW CERYMCATIM INUMBER ,
State of Florida, County of'sk A&CX4
T r ag f was signed bdom me 002Yday Of
Apm 2&sfift &tak
who is puwmrly Im@wn�L_or lum produted a
as identification. as identification.
STAMP
Signature of Naftry Pubic SANMA L. POLANIs U61
W_=12" of runut:
Notary S
PUb"C -State of Florida
Commission
if GG 212026
PIMA - .... Print NatXP re Apr 29, 2022 rubfiNateof Nary Bonded throw I WHY Assm,
Notary Public State of Florida
Amy L. Alexander
Revised 1111612016 My Corrtmi3�sion GG 1487M
X1 E*res 101002021
a EO%^ H I