HomeMy WebLinkAbout#2012-0517 Electrical Sub-AffidavitPERMIT# OQ/Z Q 51 7 ISSUE DATE 3/y�L�
COUNTY '
_ fJL—Q.. _R. 1--D—A-..
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
_�of2T�icoh s 1<ttir.ov�e l,ir ✓ f /Ibmt Aia•%, -7h� have agreed to be
(Company Name/Individual Name) '�
the Electrical Sub -contractor for Thompson's Remodeling & Home Repair, Inc.
(Type of Trade)
For the project located at
(Primary Contractor)
4
(Project Street Address or Propeliy Tax ID #)
It is understood that, if there is any change of status regarding our participation with the above mentioned
project, the Building and Cade Regulation Division of St. Lucie County will be advised pursuant to the
filing of a Change of Sub -contractor• notice.
CONTRACTOR (Qua Mier)
RIND
303Pf
COUNTY CERTIFICATION NUMBER
State of Florida, County of Indian Rivef
The foregoing instrument was signed before me thisZa day of
w6e —,20Liby Ronald Saxonmeyer
who is personally.hnown ✓bOr has produced a
as identification,
STAMP
Signature of Nm(ry Public
P'
"""'u&,c RAVINA MICHELLE BARKLEV
,g. `Commission#GG174094
:a€ Expires February 3,2022
Bonded Thm Troy fain lnsurence 800-385-7019
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SUB -CONTRACTOR SI91 ATU Qualifier)
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PRINT NAME
3v3Pt
COUNTY CERTIFICATION
State 0f Florida, C01111ty Of
The foregoing instrument was signed before me this �'41Ay of
{�Y(CLtci , 2(, bysir " J14�rrk, 161Aa
who is personally ]mown � at, Ims produced a
AS IdCn11fICAtrOn.
l�1CG•% � �- STAMP
Signa�ary 1 lie
Print Name of Notnry Pnblic
:�.F=y�;.i, RAVINAMICHELLE BARKLEY
Commission # GG 174094
:;a; Expires February 3, 2022
h' Banded Thin Troy Fain lnsurance 800-385.70f9 PO