HomeMy WebLinkAbout2-Electrical Sub 4PERMIT H ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
•
- I ` Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Robert Borkowski have agreed to be
(Company Name/Individual Name)
the Electrical Sub -contractor for Venergy Group, LLC
('Type ofTrade) (Primary Contractor)
For the project located at 3130 Seminole Road, Fort Pierce, FL
(Project Street Address or Property Tax ID tl)
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.
CONTRAC`rOR S GNAT'URR (QunllRcr)
Howard Ehrsam
PRINT NAME
3 IL /P9
COUNTY CERTIFICATION NUMBER
State or IN0I'ida, COnnnty Of ST . L V i 1l
The foregoing Instrument wits signed before one this Z$ slay of
2011 by (-Fow ARA OH2sAM
who Is Person ally known Xnr has Produced a
its Identificnlion.
l.S1g n tireof Nolm•y Public
�,5.1 vA '-0pJ4A WH .-rO
Prhd Nnnm of Nolmy Pnhllc
Revised II/IG/201fi
SUB -CO TRACTOR SIGNATURE (Qualifier)
Robert Borkowski
PIi1N'r NAME
323Gy
COUNTY CERTIFICATION NUMBER
Since or Florida, County of ST•LJCII
'1'hc foregoing hntruntent was signed before nnc this znA day of
ES �"A 2071,by 7aQ2R'Y Zee RkowSK I
who is Personally known % has Produced it
its Identlacnlion,
P
STAMC� STAMP
'i I e of Notary Public
JOSHUADAVID WHITE
MY COMMISSION # GG 90170A
EXPIRES: Au0usl2M1, 2024
Nafmq�
N n-R
;�'":o��,•• JOSHUADAVIDWHITE
MY COMMISSION # GG 981704
EXPIRES: August24,2024
Bonded Thm Notary Public Undemilers