HomeMy WebLinkAboutSub Contractor agreement Plumbing TKO signedPERMIT # 2003-0366 ISSUE DATE I
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
TKO Plumbing Inc
(Company Name/Individual Name)
,the Plumbing
(Type of Trade)
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Sub -contractor for Deb Lundgren
(Primary Contractor)
For the project located at 4710 Palmetto Dr, Fort Pierce Florida 34982
(Project Street Address or Property Tax ID #)
have agreed to be
Tt 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.
CONTRACT61k SIGNATURE (Qu"er)
Deb Lundgren
PRINT NAME
Owner/Builder
COUNTY CERTIFICATION NUMBER
State of Florida, County of
1.4-�,06p-
SUB-CONTRACTOR SIGNATURE (Qualifier)
Kevin W 013rien
PRINT NAME,
COUNTY CERTIFICATION NUMBER
State of Florida, County of
The foregoing instrument was signed before me this day of The foregoingfustrument was signed before me this
20,10- 20 by
who is personally known or has produced a who is personally known or has produced a
as identification. ation.
as identification.
0
1S) FRIED
-
Signature of NdaK Public ubliG tato of FlutsJgulat-re of Notary Public
050502
Comm. Expires Dec 52020
A/". 60
Print Name of Notary Public Print Name of Notary Public
Revised 11/16016
day of
STAMP
FLORIDA INDIVIDUAL ACKNOWLEDGMENT
F.S. 1117.0503) — Effective January 1, 2020
State of Flori
County I
LINA URIOL
Notary Public - State of Florida
Commission 9 GG 351741
-,"-two
My Comm, Expires Sep 27, 2023
Place Notary Sea/ Stamp Above
The foregoing instrument was acknowledged before
me by means of
VPhysical Presence,
— OR —
M Online Notarization,
this ze�day of m?o'e'f 4y"2.—Z=?2-2� ?by
Date Month ear
Name of Person Acknowledging
Signat re of Notary Public — State of Florida
Name of Notary Typed, Printed or Stamped
171 Personally known
19produced Identification
L,1
Type of Identification Produced. E C—
�' I IWTN��
Completing this information can deter alteration of the document or
froodulent reattachment of this form to on unintended document
Description of Attached Document
Title or Type of Document:
Document Date:
Signer(s) Other Than Named Above:
61:)2019 National Notary Association
M1304-11, (01/20)
Number of Pages: