HomeMy WebLinkAboutSubcontractor Agreement PERMIT# D �� j J ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
i`,I^= ^`�Y Building & Code Compliance Division
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BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
PA Jig- F-)e-r-+r'C-J Se V i Ee 5 E , �G have agreed to be
(Company Name/1�jdividual Name)
the F•J�-I-r' Sub-contractor for
(Type of Trade) (Primary Contractor)
For the project located at a?,jp(o �. �J9 fib' s-}- e r�� -:34 q� 1
(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.
kA ;P Ak
CONT RR NAT E(Qualifier) S RACTOR SIG AT E(Qualifier)
AACC Pr
PRINT NAME PRINT NAME
COUNTY CERTIFICATION NUMBER 1 COUNTY CERTIFICATION NUMBER
State of Florida,County of S- , /l.l���i� e, State of Florida,County of f
The foregoing instrument was signed before me this 13 day of The foregoing instrument was signed bef re me this day of
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yy��,,��p^� ,20 b ,2,n,''tt,b W�1 t�
� �L Y
who is personally known_or has produced 1 who is personally known or has produced a
as identification.awuu&
a 'fication.
�1v" �, r
STAMP STAMP
Signature of Notary PublicU &4mr J� c � Sign re of Notary Public
OVL�V 1� z o-v'd ,4/�
Print Name of Notary Pubf c Print Name of Notary Public
t)
sue=`1 pUDREY g.yUMf'{iREY David Raymond Prue
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NOTARY PUBLIC
MY coPAMISS1ON I# J-3 STATE OF FLORIDA
EXPIRES:�9ah 6,t11iComm#GG287052
Nagyu Revised 11/16/2016Expires 1/26/2023
PERMIT# 1910-0065 ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
l ` I Building & Code Compliance Division
o
-- ---- --- BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
ADMIRAL PLUMBING SERVICE,A SERVICE EXPERTS COMPANY/RICHARD BASSOFF have agreed to be
(Company Name/Individual Name)
the PLUMBING Sub-contractor for
(Type of Trade) (Primary Contractor)
For the project located at 2306 S 39TH ST, FORT PIERCE, FL 34981
(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.
LA&
4 _
CONT OR SIGNATURE.(eQuualirter) SUB-CONTRACT ATURE(Qualifier)
RICHARD BASSOFF
PRINT NANTE PRINT NAME
C C, �5 y CFC1426115
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER
State of Florida,County of��i UC State of Florida,County of PALM BEACH
The foregoing instrument was signed before me this 18"day of The foregoing instrument was signed before me this ITTH day of
20L!))by MARCH 20�,by RICHARD BASSOFF
who is personally known or has produced a 11 who is personally know5,Y-,.r has produced a
as identification. V as iden'tcation.
r
&���STAMP1911411,J4STAMP
Signature of Notary P b c U i nature of Public
yy� r JACQUE ZEE GEORGESCU
Print Name of Nptark,Pu lic Print Name of Notary Public
•, Nototy Public State of Florida
Jst gW1ne Geo���1
•{V PU' AUDREY B.HUMPHRF57�8717 :-,
W COMWlon GG 233150
E*M 01/2812022
{�1YCOMMISSION#GG
Revised 11/162016 EXPIRES: Patch 6,2023
ii;,d Thru Notary Public U drrar.