HomeMy WebLinkAboutElectrical Sub Agreement Form SignedPERMIT #
ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Di -no x
I_ L i2 Lw t
BUILDING PERMIT
SUB-C NTRACTOR AGREEMENT
Joe Ciceri Public Service INC DBA: Electr cal Works
(Company Name/Individual Mune)
the Electrical
( Type of Trade) — -
For the project located at 112 N Erie Dr Fort
(Project Street
It is understood that, if there is any change of
project, the Building and Code Regulation
ding of a Change of Sub -contractor notice.
( ON'I'RMITOR SIGNATURT (Quallfier)
Samuel R Taromino III
PRINT
IH11127532
State of Florida, County of
The foregoing instrument was signed before me this 1 day of
C� 20 U b-
Q� �)
who is personally known! has produced a
s i cntiticatimt.
ST
Signature of Notary liublic V
Print lame of Notary Public
►"" �u'-•
. �•�: VALERlE JEAN UCOE
Revised 11f16/2016'' Q`"
Notary Public - State of Florida
Commission X HH 077694
oFFl°° My Comm. Expires Jan 5, 2025
Bonded through National
Notary Assn,
have agreed to be
Sub -contractor for Champion Home Builders INC
(Primary Contractor)
FL 34946
or Property Tax ID #)
regarding our participation with the above mentioned
of St. Lucie County «vial be advised pursuant to the
SUB-C i T 1CTOR SIGNATURE (Qualifier)
Joseph B Ciceri
PRINT NAME
31632
COUNTY CERTIFIC,M0 N7 N4-11i3ER
State of Florida. County of Lake
The foregoing instrument was signed before me this 8th day of
March 20 2;,,, Joseph B Ciceri
a
known XX or ha. roduced a
Z7��L
STANIP
Signature ofNotary Public
Dana K Ostrom
Print Name ofNotary Public
asp n� Notary Public State of Florida
a° 4 Dana K f'strom
cC e My. ^vmmission GG 327801
Expit0s04/2512023