HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENTPERMIT # fts.ous� I ISSUE DATE
Blosser Electric
(Company Nam
the Electrial
__�Type of Trade)
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB-C.ONTRACTOR AGREEMENT SCANNED
BY
St. Lucie County
have agreed to be
Name)
Sub-cofitractor for DR Homes 12662
For the project located at 1809 Totten Rd #2417-323-0004-000-6
(Project Street Address or Property Tax ID 9)
Contractor)
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
filing of a Change of Sub -contractor notice
CON7TRAR SIGPTIPE (Qualifier)
PRINT NAME
01
9 S-6 S
COUNTY CERTIFICATION NUMBER
State of Florida, County of
The foregoing instrument was sig his A day of
ZRIC - 2011by—=
who is personally known —or has produced
as identification.
g,.t.r OMfN.Wy �P.bliv
Print Name of Notary Public
SUB -CONTRACTOR SIGNATURE (Qualifiter)
Kent Blosser
PRINT NAME
i
to the
COUNTY CERTIFICATION NUMBER
State of Florida, County of 6r LA& a —
The foregoing instrument was signed before me this- day of
D�.mb2,r 2ol, by
who is personally known L,/or has produced a
as identification.
STAMP �" =a, 0, STAMP
Signature of Notary Public
LASHAHNA INGRAM
Notary Public. State of Florida
*=My COMM. ExPiMs Doc 20.2018
COMMIFsicn # FF 177249
Revised 11/16/2016 BOB ed through National Notary Assn.
LO.U�rip_
�kallve_(L
Print Name of Notary Public
" ..
LAURIE HELLER
....
A04'F'S
commission# GG68635
my commission Expires
February 01 .2021