HomeMy WebLinkAboutSubcontractor Affidavit Electrical! PERMIT• ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
_L_W_at_t.o_n_-_E-le_ctr_. _ic_,_1n_c_. ____ ~~---"----------~------'-'--'---have agreed to be
(Company Name/Individual Name)
the Electrical Sub-contractor for D C Construction & Company, Inc.
{Type,ofTrade) (Primary Contractor)
For the project located at . 3266 Lakeshore Driv~, Fort Pierce, FL 34949 _
(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.
CONT:Ji/1::.TURE{.,.._)
PRINT NAME
COUNT¥ CERTI.FICATION NUMBER
241':\3
COUNTY CERTIFICATTON NUMBER
Stare of Florida, County of "1.\'.Xllllo R 1\/fl,r
·fk
The foregoing Instrument was signed before me this ~ day of
Sep\e1nh:C:: ,2o_fil, by J)r,"}:~ \.tm Ca:ioh)uen
who is personalty known _or has produced a EL :::D{
State of Florld11, County of \o\ \'(W\ '(l,~/ ....
The foregoing instrument was signed before me this ~liiay of Avy-)t .. ,201\, by ~-('I\ '='• \,Ju\ ¾)t--..-
who is' pcnonally known / or has produced a nf 0-..
as identification. ,u identifitatinu.
I
STAMP STAMP
·\J2o.noo.. VV)CS)ec P:::()."¼-
Print Nume of Notary Public
Revised ll/16/2016