HomeMy WebLinkAboutelecetricPERMIT #
C3UNT Y
ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to be
( y Name/Individual Name)
the f- (_. Sub -contractor for
(Type of Trade) -
(Primary Contractor)
For the project located at L ; C _ C r ,
(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.
COUNTY CERTIFICATION NUMBER
State of Florida, County of
The foregoing instrument was signed before me this �3 `- day of
b - 20__, by KLN h� CrZ �-t
who is personally known _or has produced a
as identificatio
Signature of Notary Public — STAMP
Print Name of Notary Public 'o�."•-`�-[1b"iiC-FRILL
Commission 4 GG 964444 I
Expires April 3, 2024
Bonded Thru Troy Fain Insurance 800.385-7019'
Revised 11/16/2016
S -CONTRACTOR SIGNATURE (QuaUlier)
PREW NAME
E s
COUNTY CERTIFICATION NUMBER
State of Florida, County of .Ci U, r o
The foregoing instrument was signed /nbefore we this day of
, 20! ' by
who is personally Imown Tor has produced a
as identification.
'�r9 t' l • -7 I/"r STAMP
si ature oMotary Public
A/• e�•-ci r
Print Name of Notary Public
Notary Public State of Florida
Arlene N. Ferguson
i
My 168246
ComNmission
� H
°f w Exp. 8/2312025