HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENTPERMIT# 1804-0863 ISSUE DATE
the ELECTRICAL
(Type of Trade)
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT SCANNED
SUB -CONTRACTOR AGREEMENT BY
St. Lucie County
have agreed to be
Sub -contractor for A s r I)-)Lr Q ��l ko
(Pritnctor� I
For the project located at 10680 S OCEAN DR, JENSEN BEACH, FL 34957
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 4,C4anMof Sub -contractor notice.
COUNTY CERTIFICATION NUMBER
State of Florida, County a 1 I I If of e
The foregoing instrument was signed before me this 1 ., a�vv off Q '
who is personally know4__or has produced a
SUB -CONTRACTOR SIGNATURE (Qualifier)
(Nfnn �.bilS Y
PRINT NAME
COUNTY CERTIFICATION NUM/B�E/R��
State of Florida, County of I t I f tm May
�',ty
T. ,fo're'goi 1ng instrument was si(g�ne�dp before me thii/��'1tlayoofy�
f�.30�y �Y4lXA tr 1 K-0 h�T't
who is personally knowa—)(Or has produced a
a5ldentlBCAtiOn.
I I LJVC�C�J/ STAMP ( A V\�
Sl Wure ofNotary Publit �pwore of Notary ublic
Print Name ofJontry Public PrintName of NotaoPublic
ME
ure of FloWa
Revised 11/162016 GG 107386
021
--1 STAMP
NEE
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