HomeMy WebLinkAboutWINDRIOBRA351_813722_MIMIA00169A_Sub Contractor Form_2-11-2022.pdfPERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
Cosper Tullos
(Company Name/Individual Name)
the Electrical
(Type of Trade)
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to be
Sub -contractor for Matthew John Snyder
For the project located at 12888 Indrio Rd. Ft Pierce FL 34945
(Primary Contractor)
(Project Street Address or Property 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 C ge of Sub -contractor notice.
C CTOR SIGNAT (Qualifier)
MG4�qM Si�vi
PRINT NAME
COUNTY CERTIFICATION NUMBER �yp
State of Florida, County of
The foregoing instrument was signed before me this day of
200Vby Mw--I YL.� S n-
who is persona y known Nor has produced a
as rintirl callon.
STAMP
Si tore of Not
Pu c
1
Prin Name of Noary
Public
5�� PCB
AMY L. SUTTON
1 COMMISSION # GG333071
oFF LXPIRES: May 17, 2023
Revised 11/16/2016
SUB -CONTRACTOR SIGNATURE (Qua er)
PRINT NAME ®x r � � o
f-Gpr�1 V Kq
COUNTY CERTIFICATION NUMBER
State of Florida, County of 30` c / "'`
The foregoing instrument was signed before me this " day of
who is personally known/ or has produced a
as iden , ca 'on.
STAMP
Signatu •of Notary P c
— Arku 9W,
Print Name of Nt)ay Public
=AN