HomeMy WebLinkAboutSub contractor formPERMIT #
O u "711"
NT'Y
F L 0 R 1 D A
Jahn Pankraz
ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Company Name/individual Naltse) -- have agreed to be
the Electric
(Type of Trade)
Sub -contractor for Mite Electric, Plumbing and Air or Richard Brame
(Primary Contractor)
For the project located at 2023 Saint Lucie Blvd, Lot 200, Ft Pierce, FL 34946
(project Street Address or Property
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.
9'e,/ A",
CONTRACTOR SIGNATURE —
(Quatlferl
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PRINTNAME;
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COUNTYCERTiRtCATioiVIjtM6ElE
State of Florida, County of Q- 1,0c l f—e
The foregoing instrument was signed before me this 2 3 day of'
who is Personally known — �—
as identification. KONNI LENAE DEWITT
Notary Public - State of Florida
Commc, °p ` My Commission #s 0H 165134
Signature Of public ndeC throug{rvztiorai NotAajY p p
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Print Name of Notary Public
Revised 11/16/2016
SUB -CONTRACTOR ATURE (Qualifier}
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PRINT NAME
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COs-
UNTY CERTlF1CATIONV;1JM8FR
State of Florida, County of $_ r- (,,VC t F
The foregoing instrument was signedd' before nw this JS day of
t t U 4+ttt 20 Y Jai tf rj
who is Personally known )6 or has produced a
as identification.
Signature afNofary public STAMP
V-,Jrf"o[f—
Print Name of Notary Public
iiiY'U KONNI t.ENAE DEWITT
� Notary Public - State of Florida
i�'o`i Commission* 4H 1b5134
My Comm. Expires Dec 10, 2025
3orded through Watiorai Votary Assn.