HomeMy WebLinkAboutSub-Contractor Change PlumbingPERMIT # 201 0-0306 ISSUE DATE 7/28/2021
COUNTY
F t O R I D A
William Tillberg II
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to be
(Company Name/Individ al Name)
the Plumbing—�.�s►r��.�
(Type of Trade)
Sub -contractor for Owner Builder
(Primary Contractor)
For the project located at 1313 Lone Pine Dr Fort Pierce, FL 34982
(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- ntractor notice.
O CTOR SIG (Qualifier)
William Tillberg II
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of Martin
The foregoing instrument was signed before me this 28 day of
July 20 I by William Tillberg II
who is personally known V or has produced a
of Notary
Print Name of Notary Public
DENICE BOUCHER
Notary Public - State of Florida
Commission # HH 099492
My Comm. Expires May 3. 2025
Revised 11/16/2016 Bonded through National Notary Assn.
y(---- `___
SUB- O RACroR SIGNATURE (Qualifier)
William Tillberg II
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of Martin
The foregoing instrument was signed before me this 28 day of
July 20 Z( by William Tillberg II
who is personally known ✓ or has produced a
Notary
Print Name of Notary Public
IDENICE BOUCHERrypublic - State of Floridaommission N HH 098492omm. Expires May 3, 2025rough National Notary Assn.