HomeMy WebLinkAboutBlosser Electric Sub AgreementPERMIT # ISSUE DATE
COUNTY
F
L
O R
I D A
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
(Company Name/Individual Name)
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to be
the EAecbor Sub -contractor for ?
(Type of Trade) (Primary Contracto }
LL;L-
For the project located at
(Project Street
Tax ID #)
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)
COUNTY CERTIFICATION NUMBER
State of idseiehr, County of v
Ohm
The foregoing instrument was signed before me this _ a day of
, 20A�, by
who is personally known or has produced a A�P(l ytl 1 t
as identification.
STAMP
Signutdre of Notary
KA R E N M U R P H Y
C0C
NOTARY PUBLIC
TATE OF OHIO
Print Name of NottF€,_,y P r. .- _•
Comm. Expires
V.
08-30-2025
Fi
Revised 11/16/2016
SUB -CONTRACTOR SIGNATURE (Qualifier)
COUNTY CERTIFICATION NUMBER
State of Florida, County of.j�
The foregoing instrument was signed before me this _?�d day of
W4M)M_ , 2Q�I, by H 21 C
who is personally known _Zor has produced a
as identification.
STAMP
S gnaturc of Notary, ub is
41 iCzorn �brwr�
Print Name of Notary Public
i'�p` ' • ALISON HANSON
MY COMMISSION # GG 970043
EXPIRES; March 16, 2024
Bonded Thru Notary Public Underwriters