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HomeMy WebLinkAboutProject InformationOFFICE USE ONLY: DATE FILED: REVISION FEE: PERMIT # 9-7 RECEIPT # PLANNING & DEVELOPMENT SERVICES BUILDING & CODE REGULATION DIVISION 2300 VIRGINIA AVENUE FORT PIERCE, FL 34982.5652 (772) 462-1553 APPLICATION FOR BUILDING PERMIT DEFERRAL PROJECT INFORMATION LOCATION/SITE ADDRESS: Sc �f 54 r/Ar /1 6/6,7 DETAILED DESCRIPTION OF PROJECT REVISIONS: 00 r CONTRACTOR INFORMATION: STATE of FL REG./CERT. #: l_ �(� �c S �j Oy ST. LUCIE CO CERT. #: BUSINESS NAME: Vl :U f _ (, L QUALIFIERS NAME: ADDRESS-� erl l 0 0 f lz; CITY: & f;? STATE: 6 ,ff ZIP: 30 oa PHONE (DAYTIME): ,- �`�-,/ FAX: OWNER/BUILDER INFORMATION: NAME: _ ADDRESS: CITY: PHONE (DAYTIME: STATE: ARCHITECT/ENGINEER INFORMATION: NAME: ADDRESS: CITY: PHONE (DAYTIME): SLCCC: 9/23/09 Revised 07/17/18 STATE: rriN. r till. 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