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HomeMy WebLinkAboutsubPERMIT # ISSUE DATE PLANNING & DEVELOPMENT SERVICES Building & Code Compliance Division i I i i Ameri-Tech Plumbing BUILDING PERMIT SUB -CONTRACTOR AGREEMENT have agreed to be (Company Name/Individual Name) the Plumbing Sub -contractor for Black Street Enterprises, LLC (Type of Trade) (Primary Contractor) For the project located at 2101 N 53rd Street, Fort Pierce, FL 34946 (Project Street Address or Property Tax ID #) i 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. . �ONTRACToh SIG ATURE (Qualifier) Lionel J Dunbar PRINT NAME 26256 COUNTY CERTIFICATION NUMBER State of Florida, County of St. Lucie 4Tforegoing instrument was signed before me this/- day of I (2019, by v(4 ► Lx4L4 ,WV _wk6is personally known is _or ha p duced a as identification. x O mkt G VW l� ST NIT 05 Signa re of i otary Public v a, t7 y 2 ? Z M Kristina Davis It 0 Print Name of Notary Public c to rn oN C w w Revised 11/16/2016 11 /A411111119­4 SUB -CONTRACTOR SIGNATURE (Qualifier) Mark White PRINT NAME 19769 COUNTY CERTIFICATION NUMBER State of Florida, County of St. Lucie Th foregoing instrument was signe efore me thi�� day 2019, by is pejanally known "'or has produced a as ide ification. �� I Kristina Davis Print Name of Notary Public m O o� m M rA v� Z z m O �G au -n o�< o 00 w w