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HomeMy WebLinkAboutAnthony Potter - Revision Building Department# 7c.0° (1-c or ..1�-) OFFICE USE ONLY: DATE FILED: REVISION FEE: LOCATION/SITE ADDRESS: PERMIT # 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 OCA101 r 91 DETAILED DESCRIPTION OF PROJECT REVISIONS: CONTRACTOR INFORMATION: STATE of FL REG./CERT. #: ( p ST. LUCIE CO CERT. #: O��{ BUSINESS NAME: N� QUALIFIERS NAME. 10 ^j ADDRESS: c.IM CITY: ,DALt& C,T1l STATE: PHONE (DAYTIME): -4--'X. G -A(. - -;-Z3t FAX OWNER/BUILDER INFORMATION: NAME: AgMarjYl ca ADDRESS: 12 3Z. GG CITY: ITY STATE: ,SIL - PHONE (DAYTIME: -4?a• -M2. 11SB FAX: ARCMTECT/ENGINEER INFORMATION: NAME: ADDRESS: ZIP: ZIP: , q"c CITY: STATE: ZIP: PHONE (DAYTIME): FAX: SLCCC: 9/23/09 Revised 06/30/17 0 043 -Goo-1