HomeMy WebLinkAboutAPP INPERMIT # ISSUE DATE
1
COUNTY
F L O R I D A
Gale Insulation
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
(Company Name/Individual Name)
the Insulation
(Type of Trade)
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to be
Sub -contractor for Bela Vista Contractors, Inc.
(Primary Contractor)
For the project located at 5608 Palm Drive, Fort Pierce, FL 34982 (Property Tax ID # 3402-609-0158-000-4)
(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.
CON RACTOR SIGNATURE (Qualifier)
Marcio C. Silva
PRINT NAME
31942
COUNTY CERTIFICATION NUMBER
State of Florida, County of Broward
The foregoing instrument was signed before me this
June 2021 by Marcio Silva
who is personally known X or has produced a
as Wen . ca
gnature of -Notary Public
Hudson Lopes
Print Name of Notary Public
,uttr! HUD" LOPES
MY COMMISSON # M 134776
EXPtW; ,* 7, 20Z
. Bw4w Thu Mahn HNie Ww"INRs
30th day of
SUB -CONTRACTOR SIGNATURE (Qualifier)
Paul W. Hash
PRINT NAME
31655
COUNTY CERTIFICATION NUMBER
State of Florida, County of St. Lucie
The foregoing instrument was signed before me this 28
June ,2021,by Paul W. Hash
who is personally known or has produced a
as identification.
STAMP
rgnature of Notary Public
Jennifer Sweet
Print Name of Notary Public
JENNIFER SWEET
MY COMMISSION! HH 047613
EXPIRES: January 29, 2025
`•.Ta; tia*: ' BOrAw Thru NOW, PuEIiE lkdelxnke�s
day of
STAMP
Revised 11/16/2016