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HomeMy WebLinkAboutRevisions.OFFICE USE ONLY: DATE FILED: REVISION FEE: i 1. LOCATION/SITE ADDRESS: _ 0 u 5. PERMIT # RECEIPT It PLANNING & DEVELOPMENT SERVICES j BUILDING & CODE REGULATION DIVISION 2300 VIRGINIA AVENUE FORT PIERCE, FL 34982-5652 (772) 462-1553 FAX (772) 462-1578 APPLICATION FOR BUILDING PERMIT REVISIONS PROJECT INFORMATION' DETAILED DESCRIPTION OF PROJECT Revised 07/22/2014 CONTRACTOR INFORMATION: ; 9s STATE of FL REG./CERT. #: ST. LUCIE COJ.jN TY CERT. #: 6 v . BUSINESS NAME: Ln a c%s Is (�L� QUALIFIERS NAME: ADDRESS: 2(3 / �� J/rns L CITY: %4 ; r .tom f STATE: ZIP: PHONE (DAYTIME): FAX: OWNER/BUILDER INFORMATION: NAME: ADDRESS: CITY: STATE: ZIP: PHONE: FAX: ARCHITECT/ENGINEER INFORMATION: NAME: ADDRESS: CITY: STATE: ZIP: PHONE (DAYTIME): FAX: Revised 07/22/2014 rQ� X51 tOHrt '�Jh FSS d v ru„�rf ,file, 6 G+