HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENT ELECTRICALPERMIT #
PLANNING & I
Building &
(Company Name/Individual Name)
the -e_kA+Cr C
(Type of Trade)
For the project located at '110 � U-5
(Project Street Adds
It is understood that, if there is any change of s
project, the Building and Code Regulation
filing of a Change of Sub -contractor notice.
CONTRACTOR SIGNATURE (Qualifier)
No
COUNTY CERTIFICATION NUMBER
State of Florida, County of B h
The foregoing instrument was signed before me this — day of
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who is personally known or has produced a I_
ISSUE DATE
SERVICES
Compliance Division
PERMIT
R AGREEMENT
have agreed to be
for '4a W (,& if
(Primary Contractor)
or property Tax ID #)
regarding our participation with the above mentioned
of St. Lucie County will be advised pursuant to the
111 vs-oz
COUNTY CERTIFICATION NUMBER State of Florida, County of a arc a t—
The foregoing instrument was si 7edbeflore me this I day of
hxk rJ- , . 20 by _% C
who is personally (mown or has produced a
as id till tion.
STAMP
Sig�natui�reof Notary Public
/
1 CAZ6rA�J��
Print Name of Notary Public
Revised 11/16/2016 No�ryPublic State of Florida
Victoria LAWS
@c Q W Commission GG 197151
o,ad� Expires 03/15/2022
R
Notary Public State of Florida
Victoria Laws tv
My Commission GG 197151
Expires 03/15/2022
STAMP