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HomeMy WebLinkAboutRoofer sub permit completeFRMIT# ISSUE DATE PLANNING & DEVELOPMENT SERVICES Building & Code 1 fcos gyre Coasf pay; i nc, (Company Name/Individual Name) the Roof ),I C (Type of Tr For the project located at al, de. Division PERMIT R AGREEMEI have agreed to be for -)(3r;a✓r Lean (Primary Contractor) or i'roporty'I aY U) N) 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. C RACTOR SIGNA U e SUB -CON CTO (Quailrier) d�ric.rt P l y]N/hA/M�nR/J^ COUNTY OERTIFICAT State of Florida, County ON R r �l 4 foregoin 'nstrume-n�ttlwas si befpr e t tX, d of ilh�—v 20, by who is personally known or has produced identification. STAMP Public of Notary Public RACHEL ANN VOSSEN i•� �'• Notary Public- State of %le'ida F +. My Comm.Erpires Aa'c. 2022 Revised 11/1612 fi;"'��--"aoudad throu9b National Notary Assn. f f;a✓1 A0, )Of'ry PRINT NAME ccc 1 3 COUNTY CERTIFICATION NUMBER State of Florida, County of L tic L The foregoing,instrument was signed before me this �; day of Oaf c6er ,202,by who is personally known or has produced a as identification. JIe�' if (I STAMP Signature of Notary Public thefer G AlTtfi ZiO Print Name of Notary Public E�CVictor O Altedzio NCYtlkry Public, Stan of Florida mmbalon Expinq 11/ll6/2022MMISSIOn No, OG9 274292