HomeMy WebLinkAboutSubcontractorFormPERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
Dean A Hodge
(Company Name/Individual Name)
the Electrical
(Type of Trade)
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to be
Sub -contractor for Go Solar Power LLC
(Primary Contractor)
For the project located at 7469 Commerical Circle Fort Pierce, FL 34951
(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.
CONTRACTOR SIGNATURE (Qualifier)
Rafael Angel Gonzalez Mendoza
PRINT NAME
30869
COUNTY CERTIFICATION NUMBER
State of Florida, County of St IUCIe
The foregoing instrument was signed before me this ' day of
November 20___, by Rafael Angel Gonzalez Mendoza
who is personally known 2or has produced a
as identification.
STAMP
Signature of Notary Publ
Jackson Wi ney
Print Name of Notary Public
IlAycolrlrrasollN l�l
�,,,� f"xpirr3so9N11�04a
Revised 11/16/2016 R Mti�,/►
I. w ACTOR SIGNATURE (Qualifier)
Dean A Hodge
PRINT NAME
3 l�vt-f
COUNTY CERTIFICATION NUMBER
State of Florida, County of St IUCIe
The foregoing instrument was signed before me this 1 day of
November 20by Dean Hodge
who is personally known ?�_or has produced a
as identification.
STAMP
Signature of Nota y
ublic
Jackson McInerney
Print Name of Notary Public
r.eth,A
Notary Public state of Flow&
Jackson Nash McInerney
} r MyCWMfti0"""o31"o J
Expirft=1112024