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OFFICE USE ONLY: DATE FILED: '1 PERMIT# REVISION FEE: �5101) RECEIPT# L "t PLANNING & DEVELOPMENT SERVICES RECEIVED BUILDING&CODE REGULATION DIVISION 2300 VIRGINIA AVENUE JUN 2 5 2019 FORT PIERCE,FL 34982-5652 (772)462-1553 ST. Lucie County, Permitting APPLICATION FOR BUILDING PERMIT REVISIONS PROJECT INFORMATION LOCATION/SITE ADDRESS:. J DETAILED DESCRIPTION OF PROJECT RE NS: �d�ccv - ri Q I!/i*/ - o -- 1p 5 CONTRACTOR INFORMATION: STATE of FL REG./CERT. #: ST. LUCIE CO CERT.#: BUSINESS NAME: & . .:7-- QUALIFIERS . .:7--QUALIFIERS NAME: ADDRESS: 2 a iG CITY: /4- - STATE: 'L ZIP: PHONE DAYTIME): 39Z- Y0220 FAX: OWNER/BUILDER INFORMATION: NAME: ADDRESS: CITY: STATE: ZIP: PHONE(DAYTIME: FAX: ARCHITECT/ENGINEER INFORMATION: NAME: ADDRESS: CITY: STATE: ZIP: PHONE(DAYTIME): FAX: SLCCC: 9/23/09 Revised 06/30/17