HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENT PLUMBINGPERMIT# ]2107-0115 ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Kemp Krueger 4K Plumbing & Consulting Services, Inc. have agreed to be
(Company Name/individual Name)
the Plumbing
(Type of Trade)
Sub -contractor for Paul Jacquin & Sons, Inc
(Primary Contractor)
For the project located at 5701 Environment Dr, Ft 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.
im
CONTRACTOR SIGNATUR r (Qualifier)
Michael Jacquin
PRINT NAME
IsLKO3
COUNTY CERTIFICATION NUMBER
•VIANU1M,B,ER
State of Florida, County of & I Ct- '' Qq
The foregoing instrument was signed before me this � day of
0J jr 20L by M,(nnd.Li 16LCOdLvt
who i er ovally known or has produced a
as identification. . \
V U��•.- ��AMJ STAMP
Signature
of Notary Public-
`s WLG9 1 e' -'�. 1/0,'Ji,-S
Print Name of Notary Public
a
llotary Public State of Ronde
Valerie J Davis
My r
,,m,, aicn HH 078199
EaOmsolAW025
Revised I I/16/201ti
SUB -CONTRACTOR SIGNATURE (Qualifier)
Kempton D Krueger
PRINT NAME
1001534
COUNTY CERTIFICATION NUMBER
State of Florida, County of_<&I& UttZ
The foregoing instrument was signed before me thisr2 ° day of
�l�il1HJY.� , 20A by k2,W-)t%, "Uqe_�-
w o is personally kn wn or has produced a
as identification.
Sib fA~ery dh ic
�V� STAMP
vaw. e T
Print Name of Notary Public
Npyay PUWic State of Fta,oa
Valerie J Davis
,agpn HH 078199
Ef
� F"p", n0 0612025