HomeMy WebLinkAboutAFP Permit Electrical Sub FormPERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
- - - Building & Code Compliance Division
COUNTY
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Flamingo Signs Robert Gralak
(Company Name/Individual Name)
the Electrical
(Type of Trade)
Sub -contractor for Flamingo Signs
(Primary Contractor)
For the project located at 601 N. 39th St I Fort Pierce, FL
(Project Street Address or Property Tax ID #)
have agreed to be
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
fil ing,of a- e of Sub -contractor notice.
CONTRACTOlt 9IGNATURE(Q Her)
Robert D. ralak
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County ofly A A f t ly
The foregoing instrument was signed before me this ! day of
0` AAC-K +2012sby B04 1/ /iALAK
who is personally known ✓or has produced aPn t ✓�n r$ L{ c z rrfr'
as identification.
- ', I�
S' nature of Notary Public
k00to, 7 141,
Print Name of Notary Public
.r►ht Notary Public State or Florida
RobertM Rice
r MyCos mta 25 103595
60W
I,II4 uIQ
SUB-C URE (Qualifier)
Robert D. Gralak
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of 4Lt 4 I //
The foregoing instrument was signed before me this day of
/`MACH ,29�by
who is personally known V"'or has produced A l t'G hl LAG! trS�
as identification. ✓�/J/J
/U STAMP
Signature of Notary Public
Print Name of Notary Public
�r Notary Public State of Florida
Robert M Rice
.�; R My Commission HH 103595
A► �' Expires 04/03/2025
Revised 11/16/2016