HomeMy WebLinkAboutELECT SUBPERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
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J Building & Code Compliance Division
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BUILDING PERMIT
SIJB-CONTRACTOR AGREEMENT
ELECTRIC CONNECTION/RANDY SJAARDEMA
(Company Name/Individual
the ELECTRICAL
(Type Off ra e)
have agreed to be
Sub -contractor for HOMECRETE HOMES INC
(Primary Contractor)
For the project located at 9605 S INDIAN RIVER DR
(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.
CONT\. 'V
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PRINT
JNAME
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COUNTY CERTIFICATION NI'%I III it
State of Florida, County of 5 iiac
The foregoing instrument was signed (before me this day of
who is personally known zur has produced a
as identification.
STAMP
ignatur of Notary Public
Yce1,IfN�t t�ry�
Print Name of Notary Public Public
• ;ep rye
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Revised I1116/2015 as
NotuY Public State of Fiadtle
Melissa D Showmen
My Commission GG 294495
Ezphes Ot/24�e23
.WO -('ONY'It.U""fOR SIGNATURE (Qualifier)
RANDY SJAARDEMA
PRINT NAME
21055
COUNTY CERTIFICATION NUMBER
State of Florida, County of ST LUCIE
The foregoing instrument was signed before one this 22 day of
NOVEMBER 20_ by RANDY SJAARDEMA
who Is personally knownO 11 or has produced a P/K
as identification. SITYAN T 8ROMN OW
I +'. Notary Pubic -State of Florida
r I Cpmmissicn - G t 1
„umi hr}i ExpirP�tJ, 2022
ti l not Notary Public Bonded through National Notary Assn. '
SITYAN T BROMELOW
Print Name of Notary Public