HomeMy WebLinkAboutPlumbing Sub PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
'COUNTY
Building& Code Compliance Division
a e BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
have agreed to be
(Company Name/Individual ame)
the vtK Sub-contractor for 3&5e- 4 L..�k
(Type of T 0de) (Primary Contractor)
For the project located at R 75"6 5 644ec,• dr• ✓e- to•�- JMS&r
(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.
CONTRA IGNATURE Sq(Qualifier) SUB-CONTRACTOR SIGNATURE(Qualifier)
a6c �1/IUJC e4,,,—r ow�e.rS
PRINT NAME PRINT NAME
3Z4K'& CCFC/Y�z 60 If
C UNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER
State of Florida,County of l n- State of Florida,County of 1r �3
The foregoing instrument was signed before me this 13—day of The foregoing instrument was signed before me this day of
eAMI�gL ,20 fi by —)99 KAYq � ) 20 ,by PG�+l rOt.YiS
who is personally known,�or has produced a who is personally known_or has produced a �L ��'✓��% G 1'
��... - asidentification. i:1i RUTHANNBATISTAMORALES
as identification. 1 ANN RALES a• n!i•.
"; "' '� u COMMISSION#HH 160258 .. MY COMMISSION#HH 160258
EXPIRES. ';; :` EXPIRES:Aug �p25
1f(cc ry Pub Ur�+enailera Nolal'Public Undenw"
S gnatare o otary Public i_... S/iggnnaturree oft otary Public
11 IAI ' 7411 // `
ofia-LtA 4�, &� q 0 1.�s
Print Name f atary Public Pr r�`Name ry Pub c
Revised 11/16/2016