HomeMy WebLinkAboutElectical subcontractorPERMIT # v 1 /I ^ cZ) 0
9 — 0 (1 O 2 ISSUE DATE
r!;
7COUNTY �
F L O R I D A -
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
(Compa i�y�Name/Individua Name) '
the Sub -contractor for to
(Type of Trade) (Primary Contra for
For the project located at
(Project Street Address or Property Tax ID #)
have agreed to be
3 *9l-v
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 OR SIGNATURE (Qualifier)
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of �4.1(�
The to egoing instrument was signed before me this day of
20Z
who is personally known _or has produced a
as identification.
STAMP
Si a ure of Notary Public
A &01-.1VI
H E
Print Name of Notary PublicLEMU
SB BRFORD� of Florios HH 216910sion Expires 06, 2026
SUB -CONTRACTOR S GNATURE ualifier)
PRINT NAME
�3c�1 l
COUNTY CERTIFICATION NUMBER
State of Florida, County of Pa I I L - C `-
The foregoing instrument was signed before me this IA-y of
201iZ-by AcTiceL,` 8
who is personally known or has produced a
as tn.,.
STAMP
Signature of otary Public
I f4wwffw��
SHARON EDELL
MY COMMISSION # RH2O9199
Print Name of Notary Public EXPIRES. December 16, 2025
o�
Revised 11/16/2016