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PLANNING & DEVELOPMENT SERVICES
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
of'l'radc)
For the pl•oject located at 3130 Seminole Road, Fort Pierce, FL
(Primary Contractor)
Sheet Address or Properly Tax ID ti)
It is understood that, if there is any change of status t•egarding our participation with the above mentioned
pfoject, the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the
filing of a Change of Sub -contractor notice.
�L 45 t=1'/ / CONTRACTOR SIGNATURE (Qualifier) SUBMONTRAC'1.OR SIGNATURE (Q_ualifier)
Howard Ehrsam Robert Borkowski
PRINT NAME PRINT NAME
3 L7Y9 3Z3 6 y
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER
State of Florida, Comity of VV.L VC,L State of Florida, County of ST./_UC I(%
"1'be fm•egoiug instrument was signed before are fbis z� day of The foregoing instruntcot was signed 6efm•c me this ZAd_ day of
) A .i A. -.(., , 2k? 2, by _ H-oW.LRD 43Q.vA , 20Z21 by og ZC i t�ARtawS K
wlm is personally kaolva Kor has produced a who is persoonlly known �Lor has Produced a
as identification.
(/J/ as ldcali0cnllon.
STAMP STAMP
Ifire of Notary Public SI lure of Notary Public
�)OSHVA 1)AVtiI wH,Tc JJS'4VA NVIb W+4I't'Ls
Print Name or Notary Public _ Prhrl Nome of Notary Public
'M�>."'••. JOSHUA DAVID WHITE
MYCOMMISSIONNGO9B1704 .,
.,�vp JOSHUADAVID WHITE
% o EXPIRES: August 24, 2024 € MY COMMISSION 4 GG 981704
Bandod That Notary Public thdemilau s xt,(,7 EXPIRES: Augus12412024
Revised ll/IGI201G `i.... °�' Bonded Thru Notary PublicUidervn0ars
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