HomeMy WebLinkAboutPipe Connection, Inc.PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
i Pc �� 1i CG7-i r> N t A)c have agreed to be
(Company Name/Individual Name)
the Sub -contractor for �4 N-i'Ttl. E to.J
(Type of Trade) (Primary Contractor)
Fortheprojectlocatedat I 0. 1 ��l ��RLli 1 �'L fi�I
(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.
CON CTOR SIGNA
bLlak�C�t--1 {�-
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County o1" %
The foregoing instrument was signed before me this I a dayof
�t'it er t"1, c,i_,20 4bY OALi 31,' 8D, ! y)l t �.
who is personally known ''� or has produced a
as idenl� ticafion.
6LA�uT'�. ]...,. 3'�"�G�SA X\1. STAMP
Signature of Notary Public
Print Name of Notary Public
<�A ;°�
RDBIN H STILLFRIED
Commiselon p GG 355225
,�
Expires November 14, 2023
'For FLOP
Bonded Tluu Budget NotarySem4ee
Revised 11/16/2016
UB-CONTRACTOR SIGNATURE (Qualifier)
PRINT NAME
COUNTY CERTIFICATIONNUMBER
n
State of Florida, County of 7 �\(AZY' I V -)
Tnhte foregoing instrument was signed before me this S day of
,20_,�Q by UcZ i: A 6ILy ICtI
who is personally known *'~ or has produced a
aS iden Ication. g8
uAAi t;V. X,.. :4.._.L STAMP
Signature of Notary Public
Priut Name of Notary Public
�ehP'o4z- ROBIN H STILLFRIED
�� �' Commission#GG 355225
m
c Expires November 14, 2023
� OF F�aP Banded TMU Budget Notary SeMcee