HomeMy WebLinkAboutSubcontractor FormPERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
Stony Electrical Contractor LLC
(Company Name/Individual Name)
the Electrical
(Type of Trade)
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to be
Sub -contractor for RJM Custom Homes
(Primary Contractor)
For the project located at 1621 Timberlake Drive, Ft. Pierce FL. 34947
(Project Street Address or Property Tax ID #)
Tt 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.
CONTRACTO iGNATURE (Qualifier)
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PRINT NAME
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COUNTY CERTIFICATION NUMBER
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State of Florida, County of N& ,'� k_
The foregoing instrument was signed before me this day of
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who is personally known _or has produced a
as identificas nl� A
Signature of
nt Name of Notary Pu
Revised 11/16/2016
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SUB -CONTRACTOR SIGNATURE (Qualifier)
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PRINT NAME
COUNTY CERTIFICATION NUMBER �y�
State of Florida, County of -)`�'p
The foregoing instrument was signed before me this It day of
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who is persona114known has produced a'TAX - *7 - G,5-2'► -6
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