HomeMy WebLinkAboutRevision; Application for Building Permit 1709-0086OFFICE USE ONLY:
DATE FILED: J ! ! 1 -6
REVISION FEE:. -7S-
FILE COPY PERMIT # 1 r7
0 9- 0 46U 6
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: 2 0 0 ,�- 5 !�7U L4 C.- K S ' 4y
DETAILED DESCRIPTION OF PROJECT
REVISIONS:
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CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #: -L (e `T ;
BUSINESS NAME: GouudJ nc Ca
QUALIFIERS NAME— i lice pf i
ADDRESS: /0362 S V` C�
CITY: flSL STATE:
PHONE (DAYTIME): 72 -
OWNER/BUILDER INFORMATION:
NAME:
ADDRE;
CITY:
PHONE (DAYTIME:
T
ARCHITECT/ENGINEER INFORMATION:
NAME: y" A f U Gyp � -4 F.
ADDRESS: 7.2 '59-
�oe Sf L,.c=iP
CITY: STATE: _
PHONE (DAYTIME)':- Z
SLCCC: 9123109
Revised 06130117
RECENED
MAR 0 9 7018
Permitting Department
st. Lucie Count,
ST. LUCIE CO CERT. #:
FAX:
ZIP:
A