HomeMy WebLinkAboutJackieSubContractorFormStLuciePERMIT # 12106-0455
ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
Big Daddy's! Jackie Peterson
(Company Name/Individual Name)
the Plumbing
(Type of Trade)
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to be
Sub -contractor for Big Daddy's/Jackie Peterson
(Primary Contractor)
For the project located at 540 Pulitzer Road Fort Pierce, Florida 34945
(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 Chapge of Sub -contractor notice.
ORISTGIVATURE (Qualifier)
Jackie Peterson
PRVa NAME
32417
COUNTY CERTIFICATION NUMBER
State of Florida, County of Polk
The foregoing instrument was signed before tree this 16th day of
June 2QA5 by Jackie Peterson
who is personally known -or has produced a
as id ntificati
STAMP
rotary Public
Kerri Ann Futrell
- _.m% Y%AM
EI ANN
--r. Notary Public
�- i Comte; .
_ ASS;�
Bonded through
R Sri cd 11 1 2 1
NT#*r,ToR SIGNATURE (Qualifier)
Jackie Peterson
POINT NAME
32417
COUNTY CERTIFICATION NUMBER
State of Florida, County of Polk
The foregoing instrument was signed before me this 1 6th
June , 2al, by Jackie Peterson
who is personally known or has produced a
s identification
Sigh'aftWeyof?Yatary Public
Kern Ann Futrell
.. ���
�-'° - ERR[Op My ?
rn
arnm,�8
Bonded ffirc,
.
t`ry Assn
day of
STAMP