HomeMy WebLinkAboutElectrical Sub Agreement Permit #2109-0357 PERMIT# 2109-0357 ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
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Building & Code Compliance Divisionti4iV11
I BUILDING PERMIT
41111HU11 11 Will I:ill'111!1W1I1IP SUB-CONTRACTOR AGREEMENT
C—',0A7��- r have agreed to be
(C mpan Name/lndivi ualName) Paul Jac uln & Sons, Inc
the �'C� t'1'G-Gt\ Sub-contractor for q
(Type of Trade) (Primary Contractor)
For the project located at 5701 Environment Dr, R Pierce, FL 34981
(Project Street Address or Property Tax 1D#)
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.
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CONTRACTOR 04ktURE(Qualifier) dsuia- N CTOR SI E(Q l'
Michael Jacquin C--
PRINT NAME PRUNIT NAMEV
N40 3 1300 7 Ct
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBE
State of Florida,County of Stale of Florida,County of au
The foregoing instrument was signed before me this day of The foregoing Instrument was signed before me this day o
20 ,bye C 1 1AWL 20 by
who is personally known or has produced a who is personally know'nCf-�or has produced a
as identification. a4ident, tion.
ySTAM1IP STAMP
signnture or Notary Pu lic SiNotary'Public
c+ BARBARA D MOLINE
Commission#GG 166267
Print Name of Notary Public Print Name or Notary Public ExpiresAp617,2022
SOFA. OWKWTTru6udpett(bgScei•I m
t4a,ly Pubic State of Ronda
Naiads �Y�HH 078198
Efj AAy CommrswnE,pras 0110612025
Revised 11/16/2016