HomeMy WebLinkAboutPlumbing Sub- DO NOT USE PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
•
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
have agreed to be
(Company Name/Individual Name)
the . �:))\.I& f'k L, c Sub-contractor for
(Type of"Trade) (Primary Contractor)
For the project located at I Q'1�?j y�
(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.
s
F
CONTRACTOR SIGNATURE(Qualifier) 1Wry.4NTRPACJOR SIGNATURE(Qualifier)
__
PRINT NAME PRWT NAME
n t
"�v � ��c/, � 19gl
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER
State of Florida,County ofC,t C State of Florida,County of PC{ =iz-'CV)
The foregoing instrument was signed before me this day of The foregoing instrument was signed before me this t5" dayof
20��by A cku CYl S m i4 V
who is personally known or has produced a 1 [ who is personally(mown_or has produced a
as identification. as identification.
STAMP U: STAMP
S' 4ueof otary Public Signature of Notary Public
in-rName of Notary Public Print Name of Notary Public
�X'IpV Notary Public State of Florida
`A Lisa Bonura y Pu, '� S#aLe Oi Florida
a My Commission GG 223725 Robert Blauvelt
Revised /1'$/ Expires05131/2022 My Commission GG032763
r--xoires 09/22/2020