HomeMy WebLinkAboutGennaro Sub Forms PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
� �. Building & Code Compliance Division
BUILDING PERM IT
SUB-CONTRACTOR AGREEMENT
John Jacobs Construction Inc. have agreed to be
(Company Name/Individual Name)
the Plumbing Sub-contractor for John Jacobs Construction Inc.
(Type of Trade) (Primary Contractor)
For the project located at 4511-516-0084-000-7
(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 T FOR SIGN LE(Qualifier) SUB-CO RACTOR SIGNA (Qualifier)
Jahn acobs John acobs
PRINT NAME PRINT NAME
1aPg.s -_;� '� <� a <
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER
State of Florida,County of St Lucie State of Florida,County of St Lucie
The foregoing instrument was signed before me this 16th day of The foregoing instrument was signed before we this 16th day of
March 20_ by John Jacobs March 2D_ ,y John Jacobs
who is personally known—or has produced a who is personally known or has produced a
as identification. as identification.
r
ss•�
Signature al Notary Public 9� Signature oF56tary Public
Casey Binkley Casey Binkley X K C)z
Print Name of Notary Public ow Er Print Name of Notary Public W @ m
03 m� o3 I1q
is
u0 �� A
77 � G)
� o
Revised 11/16/2016 as � o
CD
CD
o iS
� m
PERMIT# ISSUE DATE
=. PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
O e c+ f i C_ have agreed to be
(Company Name/In ividual Name)the e� P_C 1 Sub-contractor for �_c,_c o�S ®n S+r u C+ ;Ci n
(Type of Trade) (Primary Contractor)
For the project located at 1 C)�C, `54 � : (D c ea— U r - 44 erN Se n cl e':'C
(Project Street Address or Property Tax ID#)
r 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.
'NC JT (Qualifier) 5 CTOR IGNA E(Qualifiier)� Be)t�r4 in 1''1
PRINT NAME PRINT NAME
) 9 a - "
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER
State of Florida,County of S4 - L la r' State of Florida,County of 5� ' L
The Foregoing instrument liras signed before me this day of The foregoing instrument was signed before me this � day of
rC 20aA by PS 1R �Gt['[' a rC h 20 Z(,by 1lU C'< ) h
who is personally known kor has produced a who is personally known or has produced a
as identification. as identification.
let
Signature o Votary Public 7 Signature of Tq0ary Public °Abe
C r m�nZ
Print Name of N tary Public m o eyo 7 Print Name of otary Public o Ko B
3
J 5E
�3 W� CC. xK.
NN S1- p�'C
CL
� O
Revised 11/16/2016 0` o
o d