HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENT - ELECTRICALPERMIT # r j j f ,y / (� ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
•
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Caave agreed to be
(Company Name/Individual Name) __J `
the z•j -eC+r � Ca _A Sub -contractor for S-'Co L_GL v t_;_Y`1S �J
(Type of Trade) (Primary Contractor)
For the project located at C L � � l ' s h-1 ni 1, jh:� F��
(Project Street Address or Property Tax ID #) _ ?Lf010( D
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.
(Qualifier)
� r
PRINT NAME^
COUNTY CERTIFICATION NUMBER
State of Florida, County of SL
The foregoing instrument was signed before me this 15
1kday of
J a J4- 20 �"r DyI % Ci l�> 1li S Kam{
who is personally known )Loll has produced a
as identification.
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STAR
Signature of Notary ubri
PrintNamef Notary Public a N
c��mw
W V X 4i
Revised 11/16/2016 * o •,
195►.•
SUB -CONTRACTOR SIGNATURE (Qu xer)
PRINT NAME
IZ'n-
COUNTY CERTIFICATION NUMBER
4 {�
State of Florida, County of c t
The foregoing instrument
'w�as signed before me this t - � day of
jLI f� le , 20�-by E i r
who is personally known X—or has produced a
as W ification.
Sig tore of Notary ' lic
Print Name of Notary Public
STAMP
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