HomeMy WebLinkAboutPlumbing Sub contractorPERMIT# i 9OS _03 4 ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
4a, uo"
ompany Name/Individual Name)
the 1 01'YlLi In Q
(Type of Trade)
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to be
Sub -contractor for l i. �CJU --r�l o
(Primary Contractor)
For the project located at `'J`f ` I �_\) t
(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.
CTOR SIGNATURE (Qualifier)
1 fiDA�ti� 5 EYnIN
PRINT NAME
6 GC 150 c5 —17-7
COUNTY CERTIFICATION NUMBER
State of Florida, County of !�T Wal
The foregoing instrument was signed before we this / day of
" lam_, 20?' by 1 3h)M $4 J' r� 11,/.J
who is personally known or has produced a
as idcntilicati
STAMP
'glgalfturV of Notary Public Pftc
Print Name'of Notary Public
TRACY A PRICE
* MY COMMISSION ## C` �' Qk)56
EXPIRES: March V, it:
Revised 11/16/2016 Bonded Th,gAltt4c ySvvrc
9 GAF F\O
/l r
r
UB-CONTRALTO SIG T RE (Qualifier)
_aA t un
PRINT NAME
1 L Q?�
COUNTY CERTIFICATION NUMBER
t
State of Florida, County of'5 a te-
Thee foregoing instrument was signed before me this day of
who is personally known or has produced a
as ide ' cation.
USA LESTER
r -/) 49At NOTARY PUBLIC
gna re of Notary ub is ' c STXIW% FLORIDA
J (/ ? Comm# GG127647
_ t CSCk Les-1 -c r'-' , � CE l9 Expires 7/24/2021
Print Name of Notary Public