HomeMy WebLinkAboutRevision; Application for Building Permit RevisionsOFFICE USE ONLY:
DATE FILED:
REVISION FEE:��
PERMIT # MD"). 0006
RECEIPT # lG G3S yo
PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE REGULATION DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982.5652EFEB
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(772)462.1553
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APPLICATION FOR BUILDING PERMIT REVISIOPROJECT INFORMATION mitting
LOCATION/SITE
ADDRESS:
C2y I� S ham Or I� 1-8 (�o lk 'Pierce �C 3 �14802.
DETAILED DESCRIPTION OF PROJECT
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EVISIONS:
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CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #:
BUSINESS NAME: -PP
ST. LUCIE CO CERT. #:
QUALIFIERS NAME: W J 51
ADDRESS: `n1 A1? �G S
CITY: ins tu�Q�(� STATE: ZIP:
PHONE (DAYTIME): 3tl 979 W FAX:
OWNER/BUILDER INFORMATION:
NAME: J h
ADDRESS: 9,412
CITY: Ili
PHONE (DAYTIME:
ARCHITECT/ENGINEER INFORMATION:
NAME:
ADDRESS: F Qo
CITY: "� wA `Qrer
PHONE (DAYTIME):
SLCCC: 9123109
Revised 06130117
ZIP: ?41 1-15U
FAX: (�E920 yy o - L1.2 Ll4
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