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HomeMy WebLinkAboutSUB CONTRACTOR AGREEMENTPERMIT# 1704-0071 ISSUE DATE PLANNING & DEVELOPMENT SERVICES Building & Code Compliance Division BUILDING PERMIT SUB -CONTRACTOR AGREEMENT SCANNED BY St. LUCIP (n)ir)fi Centerline Solutions, LLC / Todd Schlemmer y a��eed to be (Company Name/IndividualName) ej� er /Je �YJ/U�°/d'�2s �.[-nc. the Electrical Sub -contractor for tic G*�-/ Anthony Ankersmit (Type of Trade) (Primary Contractor) For the project located at 5167 AlA Hwy, Ft. Pierce, FL 34949 (Project Street Address or Property 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) UB-CONTRACTOR SIGNATURE (Qualifier) Anthony Ankersmit PRINT NAME COUNTY CERTIFICATION NUMBER State of Florida, County of Hillsborough The foregoing instrument was signed before me this l6th day of June , 2017• by Anthony Ankersmit wbo is personally known X or has produced s as identification. 1 Fes-` STAMP Signature of Notary Public Debra M. Drury Print Name of Notary Public \ ,4o. pep,.; QEBRA M. DRURY . _ Notary Public - State of Florida _? ' •e P` Commission N FF 973213 �. d^ M Comm: Expires May 28, 2020 y Revised 11/16/2016 400 Todd Schlemmer PRINT NAME COUNTY CERTIFICATION NUMBER State of Florida, County of Hillsborough The foregoing instrument was signed before me this 16th day of June 20 17• by Todd Schlemmer who is personally (mown X or has produced a a•�ssiidenntif�iccation. In^ � ,� /� � Y1 e 1C - v Y • `• DY �'�l 1 STAMP Signature of Notary Public Debra M. Drury unma„ �ow'•O�Za, DEBRAM.DRURY 'milNotary Public - Stated Florida CommissionM.FF913213 My Comm: Expires May 28, 2020 ll`'