HomeMy WebLinkAbout2320 Oak Drive Subcontractor Affidavit ELEC 31103I
PERMIT # ISSUE DATE
PLANNING & DEVELOP'NIENT SERVICES
Building & Code Compliance Division
BLILDING PERMIT
SUB -CONTRACTOR AGREEMENT
J. 5C,%llil:G LAG --have agreed to be
(Company Lame -In vidual \ame)
the %%�¢� __ Sub -contractor fort!$'
(Type of Trade) (Primdn Contractor)
For the project located at 7,30_ ak—b ----
(Project Street Address or Properr: Tax ID "I
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
tiling of a Chancre of Sub-c (�jltractor notice.
CONTR. TORS t'1REf iWeY)vw%
PRINT NANIE —�S
-0 try 150733 `f _
COL"NTY CERTIFICATION NUMBER
State of Florida, County of
The foregoing instrument was signed before me this day of
,Wpi/em,&er, 20ZI. b,, _✓Otelle�_�C� who is personally known t/or has produced a
as identification.
STAMP
ignature f Notary u lic
_kke';ot / h1 ! I s_
Print Name of Notary Public /
low
*Pr'�u ALICIA PHILLIPS
•`: Notary Public - State of Florida
S� Commission # HH 35074
''�oFAE My Comm. Expires Aug 23, 2024
Bonded through Nationat Notary Assn.
11
COUNTY CERTIFICATION NUMBER
State of Florida. County of _--t
The foregoing instrument was signed before me this Y day of
who is personally known _or has produced a _— (— 1)
as identification.
STANIP
Signature oTNotary Pub c
�/Y-\ VWq
Print Name of Notary Public __
d= H.N
GL