HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENTPERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
DOUGLAS DANKNER
(Company Name/Individual Name)
the ELECTRICIAN Sub -contractor for RAYMOND MEAD
(Type of Trade)
For the project located at 9517 WINDRIFT CIR
(Primary Contractor)
FORT PIERCE 34945
(Project Street Address or Property Tax ID #)
SCANNED
BY
& L"LSe Cob*/
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
filing of a Change of Sub -contractor notice.
CON,OACTOR SIGNATURE (Qualifier)
RAYMOMD MEAD
PRINT NAME
Cv C. �s ce cQS�
COUNTY CERTIFICATION NUMBER
State of Florida, County of V66-110 La_ -
The foregoing instrument was signed before me this 7 day of
Q 20AI by RAYMOND MEAD
who is personally known `_�.r has produced a
as identification.
Signature of Notary Public
W)q,ofS N 4:!e!2'e_%&-S
Print Name of Notary Public
B-CON CTO GNATURE (Qualifier)
DOUGLAS DANKNER
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of PA(n-t C" 4A'c-
The foregoing instrument was signed before me this day of
20A by DOUGLAS DANKNER
who is personally known o has produced a
as identifi
STAMP \,
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° WANRevised 11/16l2016 •My CoExpire
Signature of
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Print Name
1.114 "U
� Public
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.. '"4TE OF
LA CII JhCr d b a., A7=Tc
4625-EastlBay.Dr., Ste 305
0envvater, FL 33764
Solar license #CVC056656
Electrical -License # EC13001300
AC License#CAC009274
LIMITED POWER, OF ATTORNEY
PERMITTING AUTHORIZkTION FORM,
12[ 14-�' v O- d-e, , owner of the property located at ?517
CPA rf. S q Q yoe--`� do hereby authorize the permitting
departmenfof LSCI, Inc. (listed below) to sign and apply for a building permit on my behalf. This
authorization is valid ONLY for the purpose of obtaining a permit to perform the solar
installation work contracted for_ The ONLY permit(s) which may be applied for under the terms
of this letter are those which the authority having jurisdiction (City or County) deem(s)
necessary under the current. Florida Building Code, given the scope of work contracted for.
Contractor (LSCI, Inc.) will be responsible for any and all fees associated with this permit
application. This authorization will remain valid until said permit is Issued by the respective
Building Department, or until thirty (30) calendar days from the date listed below have
tran pi red, whichever is less.
Homeowner Signature
Nota as to Owner
,10 Notary Public State of Florida
a°' POLLY ALVAREZ HENANDEZ
s' My Commission GG 125150
114oF ♦ti Expires 07/17/2021
////-4a& -
Printed Name Date
Notary Seal/Stamp
Sworn and subscribed before me this ;a,— day
of 20& and[ ] is personally
known or [ JpmLced Z--as identification
Current Permit Dent:
Raymond Mead - CVC License Holder
Douglas Dankner - EC License Holder
Pillar Hernandez - Permit Tech
Ariel Dent - Permit Runner
Helena Wirth - Permit Runner