HomeMy WebLinkAboutSUB CONTRACTOR AGREEMENTSCANNED
PERMRg I I ISSUE DATE I <i I-UCIe
PLANNING & DEVELOPMENT SERVICES
Building & Code Compfiance DIVISIon
At nG a/ i6fi
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification
State of Florida Certification Number (Bap......--,.
oene
lid "-.�P�✓i (�i2C�'rt'G:D G}Oft'(� G., o13 have agreed lobe the
(Company Name/individual Name)
Electric Subcontractor for Glotel Inc.
(Type of Trade) - (Prumrycontractor)
For the project located at 9650 South Ocean Drive, Jensen Beach FL 34957
Street Addressor Property Tax ID #)
It is understood that, if there is any change of status regarding our participation with the above mentioned
project, I will immediately advise the Building and Zoning Department of St. Lucie County by filing a
Change of Sub -contractor notice. (Form: SLCCDY (No. 004-00)
BUSINESS QUALIFIER (Name of the Individual shown on the Conhartues License)
NOTARIZED SIGNATURRES�A IRE REQUIRED
Business Name: Prim 1�5-164yo G o'P
Address: 3550 ADS. \(e z
CitylStatelzip: D E �t'4G1'Zy I—`— " �D
Phone: L45Z-Q)' YP- 1�5q) email: '
L7&19
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SIGNATURE r PROff NAME ` DATE
STATE OF FLORIDA, COUNTY OF`k.'iCa
THE FOREGOING EWMIUDIENT WAS SIGNED BEFORE ME THIS 492" DAY OF — .20 15
BY kb--Y--V 3�f k-\AczV1.7d WHO IS PERSONALLY KNOWN Lf�ORHAS
P7RODUCFM,
AS IDENTIFICATION.
/ a (STAMP)
SIGNATURE OF NOTARY PUBLIC PRINT NAME OF NOTARY PUBLIC
SLCPDSt08/06/2014 _
ap.," LINDA PALOZZOLA
Commission # FF 110250
My Commission Expires
Aprll 07., 2018