HomeMy WebLinkAboutSub Contractor - Electrical PERMITA 211+0-0320 ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
• • BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
have agreed to be
(Company Dame/Individual Name)
the ,` it Sub-contractor for Advanced Hurricane Protection
(Type of Trade) (Primary Contractor)
22-100-0 21
For the project located at #4511 811 00 Aqua Ra Drive, Jensen Beach FL 34957
(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.
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TRACTOR SI T RE(Quali i SUB- aNTRAC SIGNATURE(Qualifier)
0 osV1t�t y"1�11 �! WY1 '�`•_
PRINT NAME PRINT NAME
CBC1259339 ` _q.5
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER
State of Florida,County of Sep t"1 State off Florida,County of _�
The foregoing instrument was signed before me this f s day of The foregoing instrument was signed before me this ( day of
2u�y by
N Cs , r
V cm liL✓� 20 by y�v1^lr V In l.lr
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who is personally known A/—or has produced a who is personally known�or has produced a
as identification. as identific
t2lC..Lir .if � STAMP STAMP
Sigmture f Notary Public Signature of Notary Public
Melissa A Ewoldt t M •
Print Name of Notary Public Print Name of Notary Public
MELISSA A.EWOL::DW COMMISSION#HH #VP Notary Public State of Florida
EXPIRES:August 10, i'4F,PubiicUrs Laura Townsend
.FpdFtiC. Bonded My Commission
HH t7$635
Revised 11/1612016 °Ft` Exp.9!#312425