HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENTPERMIT# 2109-01.77 1
ISSUE DATE 10/14/21
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
CEI t /.C.
have agreed to be
(Company Name/Individual Name)
the Electric Sub -contractor for Jacob Industries, LLC
(Type of Trade) (Primary Contractor)
Jose &,rcei-o
For the project located at 7650 S Ocean Drive, Jensen Beach, FL 34957
(Project Street Address or Property
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 LL4�'�-(-V
fThe foregoing instrument was signed before me this '1 ` day of
LL.
who is rsonally k w ,,_or has produced a 1
as identification.
~"---- STAMP
signatu a of Not iAvb& ;
Print Name of Notary Public
Revised I lltf1f20t G�'zr
SUB -CON CTOR SIGNATURE (Qualifier)
Jose Barreto
PRINT NAME
EGI'3oo7 '109
COUNTY CERTIFICATION NUMBER
State of Florida, County of_A_AA(,
The to Ding Instrument was signed{{ before me this �fday of
Ou 28 by ,IOit- 86,(r 'I-o
who Is personally (mown Y� or has produced a
as ideoti ti
STAMP
Signature f mry Pubtic
joss.e Ac,,s4..
Print Name of Now" Public
y>qg
+F A
IOSSIE ACOSTA
Notary Public -State of Florida
Commission t GG 194028
-
MY COmm. Expires Ma, 11, 2022
...-•80�ce through National Notary Assn.