HomeMy WebLinkAboutleach sub contractor agreement plumbingPERMIT #
ou
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D R I
D A
ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to be
(Company Nalne/Individual Name)
the Sub -contractor for o CK�<�
(Type of Trade) (Primary Contractor)
For the project located at � , 'f$ Q ,— 3 Z-Cs k,,— -0 1� '
(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.
CONTRACTOR SIGNATURE (Qualifier) SUB -CONTRACTOR SIGNATURE (Qualifier)
PRINT NAME
COUNTY CERTIFICATION NUMBER State of Florida, County of lGLt l
The foregoing instrument was signed before me this day of
, 20_, by
who is personally known or has produced a
as identifica ' r
� a", STAMP
Signature of Notary Public
Print Name of Notary Public
PRINT NAME
c7rc f aryl1LI
COUNTY CERTIFICATION NUMBER
State of Florida, County of
The foregoing instrument was signed before me this day of
, 20_, by
who is personally known or has produced a
as identification.
1 A— J
Signature of Notary Public
Print Name of Notary Public
STAMP
Revised II/16/2016