HomeMy WebLinkAboutSUBCONTRACTOR AFFIDAVITPLANNING & DEVE.LOPMENT SERVICES
Building & Code Compliance Division
DOUGLAS DANKNER
(Company Name1ndividual Name)
the ELECTRICAL
(Type of Trade)
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to be
Sub -contractor for RAYMOND MEAD
(.Primary Contractor)
For the project located at 2405 COOLIDGE RD, FORT PIERCE, FL 34945
(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
riling of a Change of Sub -contractor notice.
7
./"
C ONTRAc-FOR SIGNATURE. (Qualifier)
RAYMOND MEAD
PRtNT NAME
CVC056656
COUNTY CERTIFICATION NUMBER
State of Florida, County of ST. LUCIE
The foregoing instrument was signed before me this I l � day of
OCN 44, . zeal, by .� �
who is perwnally know
u� or has produced a
as idelltificad n.
__ sTAn�P
Sfgna re o \o y ublic
__ Fr (Ac\ c
Print ;Name of Notary Public.��
�y►� Notary Public State of Florida
.t' Frank M Perry Jr
My Commission GG 336129
y
Expires 06/2812023
ReNised 11'1612016
� ►t`t9.11.i
CONACT�?\ATUKE {QualUter)
DOUGLAS DANKNER
PRINT 'NAME
EC 13001300
COUNTY CERTIFICATION NUMBER
State of Florida, County of ST. LUCIE
1..
The foregoing instrument was signed before me this l 1p�day or
who is personally know n-Z-4— or has produced a _ Y
SI AMP
Y
Notary Public State of Florida
Frank M Perry JrMy Commission GG 338129
Expires 05128/2023