HomeMy WebLinkAboutSubcontractor form, electricPERMIT # ISSUE DATE
4 PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
COUNTY
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
ARS RESCUE ROOTER
have agreed to be
(Company Name/Individual Name)
the ELECTRICAL Sub -contractor for DENNIS ZACEK
(Type of Trade) (Primary Contractor)
For the project located at 8219 E BRITTERBUSH LN
(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 SIGMA (Qualifier)
DENNIS ZACEK
PRINT NAME
CM C 1249753
COUNTY CERTIFICATION NUMBER
State of Florida, County of ST LUCIE
The foregoing instrument was signed before me this 10 day of
MARCH 2O2Qby DENNIS ZACEK
who is personally known for has produced a
as identification.
Signature o Notary Public
MIRANDA GILLIS
Print Name of Notary Public
DRIVER LICENSE
SUB -CUNT C OR SICP4ATURE (Qualifier)
JOSEPH FRICK
PRINT NAME
EC 13008558
COUNTY CERTIFICATION NUMBER
State of Florida, County of ST LUCIE
The foregoing instrument was signed before me this 10 day of
MARCH ,20t�by JOSPEH FRICK
who is personally known or has produced a DRIVER LICENSE
as identification.
STAMP _
Signature of Notary Public
MIRANDA GILLIS
Print Name of Notary Public
MIRANDAGILLIS �N! ?, MIRANDAGILLIS
�++^ • •.; ;�.. '�;;.
MY COMMISSION # HH 046650 ;, . ,; MY COMMISSION # HH 045659
EXPIRES: September 23 20244 >+ Q`. EXPIRES: September 23, 2024
Revised It 16 2016 �' #Af; . °* BMW Thru Notary Public fterwdlera ) 0p "o«: Sondod Thm Notary Public Undelwdlem
STAMP