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HomeMy WebLinkAboutRevisions OFFICE USE ONLY: p 170 DATE FILED: PERMIT# / REVISION FEE: RECEIPT# PLANNING&DEVELOPMENT SERVICES BUILDING&CODE REGULATION DIVISION 2300 VIRGINIA AVENUE FORT PIERCE,FL 34982-5652 (772)462-1553 APPLICATION FOR BUILDING PERMIT REVISIONS PROJECT INFORMATION LOCATION/SITE ADDRESS: DETAILED DESCRIPTION OF PROJECT REVISIONS: _ . i �h - r � ,r`/L l�c.n.%.,z �/'v.n /�y n 9�/4i i'f►•[3''�'�/ �` �^ /_a " �-f�� r' f�r_ '7'•t/ - 'T`j,-.cH limen�.-. ex T'h �:�Gr� 5;'cl.c P..✓o.ar�t�s= �7t�'�P'r /or YAt.c FOIST /� ! t7Jt 7'O rcl5ton{nT CONTRACTOR INFORMATION: STATE of FL REG./CERT.#:- ST.LUCIE CO CERT.#: d a y� BUSINESS NAME: A I /-r—IV c1.- (e-,V•Q� r�/y c_\0— QUALIFIERS NAME: S c-o`t'�` ADDRESS: W6 S 10 13•-;V 6 s 0 ,/6/✓e� CITY: p r S f" u_e STATE: ZIP: 3 415?a' PHONE(DAYTIME): FAX: OWNER/BUILDER INFORMATION: NAME: ADDRESS: CITY: STATE: ZIP: PHONE(DAYTPAE: FAX: ARCHITECT/ENGINEER INFORMATION: NAME: ADDRESS: CITY: STATE: ZIP: PHONE(DAYTIME): FAX: SLCCC: 9123109 Revised 06/30/17 to ,e5 toT 72 d L B yt / / t CCMTRACTCR COPY , d�-- �"' .cLd ' t» : '� 1 ,; d Lu o NL �Di� / � j�. Cd� . • h AV< Q •�GS S�Sf "f ��",tlir3 y C.4.�I�C" CsT G�JCiC! ,QyE.rJdE_,�c/�r) ✓"mss'-4,y/G�