HomeMy WebLinkAbout SUB-CONTRACTOR AGREEMENT - ELECTRICALPERMIT #
L E
ECiUNTY
F L O R I D A
'Z 1 % Z --y Oq 70 I ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
.:�W(06 .Sp K V1 r Z3, )
(Company Name/Individual Name)
the i' . �'L iY C,( A
(Type of Trade)
Sub -contractor for r
(Primary Contractor)
For the project located at �� �> i;o�o/y-lnun
(Protect 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.
t
CONTRACTOR SIGN.a URE (Qualifier)
Me I �r f-%
PRINT N.AME
3zsLto
COUNT' CERTIFICATION NUIMBER
State of Florida, County of f- _u) C (C-
The foregoing instrument was signed before me this X7 day of
20,�. by �y, 1 aV'A Pj am.
whb is pers4alhv known `�or has produced a
as identific
STAMP
SignattV'e of?i6tar- f Olic
_ G _
Print N. arMQWO E. BaMes
NOTARY PUBLIC
09 STATE OF FLORIDA
• Comm#1 GG337564
�g1 Expires 5/22/2023
Revised 11"16'2016
SUB -CONTRACTOR SIGN: IRE (Qualifier)
S�
PRINTNAME
,Z 19 �
COUNTY CERTIFICATION NUMBER
State of Florida, County of �1 L` --�
The foregoing instrument was signed before me thisy t day of
�)ULtj,20Z? by T)_I,? +f p t 1�
who is personally known or has produced a
as identi cati
STAMP
Signatu f NXF Public
6ftnu S' i a (.,-i
Print Name of Notary Tublic
,` 4A.CKAv1Ab!. LE'J/ALLE:"v
CornT!sslon # GG 344l v5
- — Exo res June i2, 2023
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