HomeMy WebLinkAboutrevision OFFICE USE ONLY: /
DATE FILED: PERNIIT#
REVISION FEE: RECEIPT#
PLANNING & DEVELOPMENT SERVICES RECEIVED
BUILDING&CODE REGULATION DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652 JUL 2 4 701.0
(772)462-1553' De artmen,
Permitting p
St. Lucie countv
APPLICATION FOR BUILDING PERMIT REVISIONS
PROJECT INFORMATION
LOCATION/SITE
ADDRESS: zz
DETAILED DESCRIPTION OF PROJECT
REVISIONS:
A b lid 0 X)
CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #: ST. LUCIE CO CERT. #:
BUSINESS NAME:
QUALIFIERS NAME:
.ADDRESS:
CITY: STATE: ZIP:
PHONE(DAYTIME): FAX:
OWNER/BUILDER INFORMATION:
NAME: / J,
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
REVISIull
Page 1 of 1
0°0
23
C14
25
Vv 11
BAS
(1296)
3 7
g UR
36 �56
25 C PAA ;
(194 ;
10
3 16
0 PAfs
(24)
i
..,. ..
LAN
RECEIVED
JUL 2 41010
Permitting Department
St. Lucie County
https://www.paslc.org/ImageSketches/sketch/123/123107_127917_l jpg 7/20/2020.