HomeMy WebLinkAboutleach sub contractor agreement electricPERMIT # ISSUE DATE
COt NTI
l L 0 P. I D R-
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to be
(Company Name/Individual Name)
the z k
k
�k t`i c,��� Sllb-contractor for"�c�t � � �1� P o� l4 5 j �.
(Type of Trade) (Primary Contractor)
For the project located at \ `� ?` �� E , 1
{Prqject Street Address or Property Tax ID #j
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.
CO RACTOR SIGNATURE (Qualifier)
PRINT NAME
COUNTY CERTIFICATION NUMBER
d�t
State of Florida, County of c. o 0 Q .
The foregoing instrument was signed before me this �� day of
,20� by
who is personally known >Q or has produced a
asidentificatio
�. STAMP
Signature of Notary Public
-1-'C(_'(ye V 'AO—z-
Print Name of Notary Public
Lf
Mr Notary Public State of F�
.TraciVelez
µy Commission GG 937771Expires 12toe/2023
Revised
CONTRACTOR SIGNATURE (Qualifier)
PRINT NAME
Lc 1 S130Sg15°
COUNTY CERTIFICATION NUMBER
State of Florida, County of � rr1' (� (,V
The foregoing instrument was signed before me this /)",(A4 day of
I'i
. cWN 4 20 /S �t�t %a,by ( h(��1"
who is personally known _or has produced a +
as identification.
�_Vck f V % 'r STAMP
Signature of Notary Public
Print Name of Notary Public
Notary Public Stain of Fbrida
Traci Velez
1,Ay Commission GG 937771
�or a
Expkrss 12/08/2023