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PERMIT # � ` � ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT RECEIVED
SUB -CONTRACTOR AGREEMENT MAR 19 1021
Permitting Dapartment
St. Lucie Courrty
JGE II
(Company Name/Individual Name)
the Electrical Sub -contractor for Coastal Palms
(Type of Trade)
For the project located at
(Primary Contractor)
Lot 6 W. Midway Rd 3304-603-0007-000-2
(Project Street Address or Property Tax ID #)
have agreed to be
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.
SIGNATURE (Qualifier)
J,Ason Hsu
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of s L w
The foregoing instrument was signed before me th11is)1 day of
20%(, by�/RSaY1
who is Eally know _or has produced a
as identification.
Z y ou .'��
gnature of Notary Public � it
DAM
Print Name of Notary Public
Clio
CA
Revised 11/16/2016'�
Sp9-CONTRACTOR SIGNATURE (Qualifier
John Gazdacko
PRINT NAME
COUNTY CERTIFI ATION NUMBER
State of Florida, County of e
The foregoing instrument was signed before me this J� day of
, 20_, by R kn 69A Z0�ACEO
who is ersonally kno or has produced a
as identification.
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ignature of Notary Public ?ems
Print Name of Notary Public
bra.