HomeMy WebLinkAboutSUB CONTRACTOR AGREEMENT5 Sc b- 44 2.7 \��ii( 'r� R 312017 6 W 7
PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
SCANNtL,
BY
St. Lucie Count,
Ascend Wireless Networks& Garth F Gahlberg have agreed to be
(Company Name/Individual Name)
the 'Z— �zl t cam, Sub -contractor for Ascend Wireless Network ZhC
(Type of Trade) (Primary Contractor)
For the project located at 6q Z5 -�k' u Ss0. V l S IAA
(Proiect Street Address or Proveltv Tax ID #)
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.
CONTRACTOR SIGNATURE (Qualifier)
/i'f04,g Zl,,/aL6ucA
PRINT NAME
CGC f S�=a 1 G l457 S
COUNTY CERTIFICATION NUMBER, 1,, ,Sy.o—'\�i
State of Florid ', County of eyta
The foregoing instrument was signed before me tkis 2y d_ayyof
20j, by ffiaA 7sf LI�V
who is personally known L"arbasproduceda
as idenfifi n. `` rr'',, a 1I//1�
f�A.l N STAMP
ature of NotalydPdblie
CD A^#J
Print NauP o5W " Pubflon- public State of Fron�a
e Lacey N Stovall
a eip¢,¢ hMy
",v 04f18201a t081]7
Revised 11/162016
SUB -CONTRACTOR SIGNATURE (Qualifier)
PRINT NAME
'C—�G\-ov
COUNTY CERTIFICATION NUMBER
State of Florida, County of'Q
--TTh\e foregoing instrument was signed before me this\ ,day of
"'�Q�bfJ 20)') byc-)" '^Y�'
who is personally lmowa �r has produced
\a's�I identification.
cation.
`��ZQ11�O,Cw� 1C9.�.1—Qfi— STAMP
Signature of Notary Public
cc.
Print Name of Notary Public
%!an
ICA LYNN CARMEANMMISSION#FFr877a9ES Janupry 7, 2019itlallotaryServica.com