HomeMy WebLinkAboutBennett Subcontractor Plumber Verification Form10062020PERMIT # ISSUE DATE 11
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Pipe Connection - Cecil Lee Marion
have agreed to be
(Company Name/Individual Name)
the Plumbing Sub -contractor for Island Kitchen and Bath
(Type of Trade)
(Primary Contractor)
For the project located at _gszg C- or,, A, L, �IZOZ � �,Q /t_S.Q&Am�ek .
(Project Street Address or Property Tax 1D #) T
IN01s1
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.
CONT CTOR SIGNAT (Qualifier) SUB-CONTRACTO SIGNATURE (Qualifier)
Justin Thiery
PRINT NAME
CBC1259508
COUNTY CERTIFICATION NUMBER
State of Florida, County of St. Lucie
The foregoing instrument was signed before me this —14-1 day of
zgapby Justin Thiery
who is personally known _or has produced a DL
as identification.
STAMP
Sutu=az
Mich
Print Name of Notary Public
Revised 11/16/2016
Cecil Lee Marion
PRINT NAME
CFC033824
COUNTY CERTIFICATION NUMBER
State of Florida, County of St. Lucie / -
The foregoing instrument was signed before me this & day of
OC4ZA 4 204?, by Cecil L. Marion
who is personally known _or has produced a DL
as identification.
_ STAMP
ignature of Notary Pu
ichael Raaz
Print Name of Notary Public
MICHAEL RAAZ
' ••• Commission # GG 318620
Expires July 28, 2023
�"I yr ruoPP Bonded TMu BudW Notary Snakes
MICHAEI.RAIQ
�
,p'`',A•• �
ComMIsston # GG 318620
Expires July 28, 2023
��rfoF�v°a�0
9ondodiMuBud9 et Notary Senkos
Revised 11/16/2016
Cecil Lee Marion
PRINT NAME
CFC033824
COUNTY CERTIFICATION NUMBER
State of Florida, County of St. Lucie / -
The foregoing instrument was signed before me this & day of
OC4ZA 4 204?, by Cecil L. Marion
who is personally known _or has produced a DL
as identification.
_ STAMP
ignature of Notary Pu
ichael Raaz
Print Name of Notary Public
MICHAEL RAAZ
' ••• Commission # GG 318620
Expires July 28, 2023
�"I yr ruoPP Bonded TMu BudW Notary Snakes