HomeMy WebLinkAboutLot 23 - Electric SubAgreementPERMIT # ISSUE DATE
_ PLANNING & DEVELOPMENT SERVICES
•
- Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
(q AZ kMIN52JAIRZZWAHave aLyreeci to hP
(Company Name/Individual Name)
the CLgM16 Sub -contractor for
(Type of Trade)
For the project located at 110
(Project
J
_6u/LT _
(Primary Contractor)
Address or Property Tax ID #)
r 8�_
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 Cyg6ge of Sub -contractor notice
CONTRACTIAR SIGNATURE (Qualifier)
PRINT NAME
3ZL56-�k
COUNTY CERTIFICATION NUMBER
State of Florida, County of��_P_
The foregoing instrument was signed before me this day of
20Zk. by
who is personally known ✓ has produced a
as ' titieation.
STAMP
a ure o ol Public I
Print Name of Notary Public
1 ii'•., JENNIFER DAVERSA
,' YP•
=°fir Notary Public •State of Florida
c` Commission a HH 056351
of rt° My Comm. Expires Oct 22, 2024
Revised I 1 i 16/2016 Bonded through Nationa! Notary As]
sr
SUB-CONTRACTOR SIGNATURE (Qualifier)
PRINT NAME
31S'7o-
COLIN 1 Y CERTIFICATION NUNIBER
State of Florida, County of s7— 4U61 45
The foregoing instrument
was signed before me this � day of
2ooi by N
who is personally known _X_or has roduced a
as identi ",n'
STAMP
Print Name of Notary Public
Notary Public State of Florida
,9` �, Kimla J. Simone
• My Commission GG 957803
+� Expues 05l18/2024