HomeMy WebLinkAboutLot 28 - Plumber SubAgreementPERMIT # ISSUE DATE
I
COUNT7A.
F L O R
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
(Company Name/Individual Natne)
the r"\ Sub -contractor for
(T e of Trade)
(Primary Contractor)
have agreed to be
For the project located at 0� Z 1� - � tA J C.E04 n _e _j ' c_5 0 t' lyC
(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 ofA Chandof Sub -contractor notice.
CONTRACTOR SIGNATURE (Qualifier)
'PRINTNAME
zyy�
COUNTY CERTIFICATION NUMBER
State of Florida, County of V t • LAC\e
(TThe foregoing instrument was signed before me this day of
v _
V�20?,bY(�d(
who is personally known 1/—or has produced a
as identification.
STAMP
ign ture of Nota ublic
Print Name of Notary Public
1Y °�e' _
JENNIfER DAVERSA
Notary Public State of "riorica
Oc F�,.
;
Commission of HH 05635'
My Comm. Expires Oct 22. 2024
..
Bonded through National Notary Assn.
Revised 11/16/2016
SUB -CONTRACTOR SI NATU E (Qualifier)
W1 One \' Lem yo'
PRINT NAME
L L tL- -ocu&
COUNTY CERTIFICATION NUUM1B,ER,
State of Florida, County of % 1 • - -:A
/The foregoing instrument was signed before me this day of
VC,�rjhCs� .201,by LgA40O1
who is personally known t"or has produced a
as identification.
Si-natuufof Notary Public
Gy'C'( jet nt'_�k fVA
Print Name of Notary Public
n' Put (oe Qr �n?o`J.nwer
rjda
Santana
MyCm744v=239
Expires 07/1b.'2022
STAMP