HomeMy WebLinkAboutElectrical Sub�C4-dc'l
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COUNTY .
IF L O R I D A "♦"
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ISSUE DAT>
PLANNING & DEVELOPMENT SERVICES
Building & Cade Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
f�
have agreed to be
(Compan
Vame%Indi-idual Name) '
the Sub -contractor for 1 f v'(25:0 A
{Type of Trade) (Primary Contractr
For the protect located at S a►.! e= ` L _
(Project Street Address or Property Tax 1D 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.
ItcaC-fSIGYATt (Qualifier)
RINT NAME
CO[ NC 6`TYl lON vl'vIBER
State of Florida. County of 5+
The Foregoing instrument was signed before me 1hk day of
.20cr�by �1
who is personally known ____or bag produced a
is identification.
STAMP
Signature of Votary Public Z% -
Printya of�attlTy ELI,i'V VAUGHN _
Slate of Fiorida-Notary Publ
^ss�r,= Comrr;ss On q GG
My Con.mis- �o 27D079
Fxprres
Rewsed 11116P_016
� _0
SUB -CONTRACTOR $1GNATURE (Qualifier)
ra
PRINT NAME
COU YTY CERTIFICATiONi N i BER
State of Florida. Couoty at +, y
The foregoing instrunwat was signed before me this ii l day of
g'1021, by
wbo is personally known or has produced a
as id e tifieation_
t /I fi STAMP
signature of Notary Plie -
4�
Print Name of Votary Public
Chlie ina Johnson
�ptP3tY � NOTARY PUBU)C
STATE OF FLORIDA
' }Comm#GG38t5t6
. 7 E ISJP EXpif@S 8m 2023