HomeMy WebLinkAboutDOC 2012-0722-001 SUBPERMIT# ISSUE DATE 12/31 /2020
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Owner / Builder Mark Walpert have agreed to be
(Company Name/Individual Name)
the Electrical, Mechanical, and Plumbing Sub -contractor for Self as Owner / Builder
(Type of Trade) (Primary Contractor)
For the project located at 5050 N Highway Al A, Hutchinson Island, FL 34949
(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 Change of Sub -contractor notice.
CONTRACTOR SIGNATURE (Q itter)
-CONTRACT R SIGNA RE (Qualifier)
PRINT NAME
COUNTY CERTIFICATION NUMBER
COUNTY CERTIFICATION NUMBER
`L' No'h
;y
State of Florida, County of S.}- Lu4",•c
State of Florida, County of 5 GS f
The foregoing instrument was signed before me this _I- day of
VP' me°=
W�\`,�
The foregoing Instrument was signed before me this d 1yo
1�
1 ]Pi _ ,2�by
rrlllll\\
N
y,
Ix (... ,2U�bY "
''/
orll
who is personally (mown or has produced a L/
3 o M
who is personally known or has produced a
�c
00
as identification.
3 o c m
as identification.
3
< m 0 a
,� n
Q°
/
K/O J S
III c) o C
ro m a
�,,, /
4A /)f1i�n.�.. [
r3 n
m 3S3
Signature of Notary Publi
Signature of Notary Public
ND
m 0 G
RR�� /�^
,yy}/
�Ld+%a' y�+
N 0 0
n
N%
Print Name of Notary Public
Print Name of Notary Public
N J�
Revised 11/16/2016
l7