Loading...
HomeMy WebLinkAboutRevisionsOFFICE USE ONLY: DATE FILED: REVISION FEE: PERMIT # 1 q t L- do35 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: LVc-lk:�- r _ 3Ysi—z DETAILED DESCRIPTION OF PROJECT REVISIONS: . AryrL • F-X,CIT/NLi CONTRACTOR INFORMATION: STATE of FL REG./CERT. #: U&' (- BUSINESS NAME: SEr`+ QUALIFIERS NAME: mf u4711&-Z_ ADDRESS: II?A -rL�- /h CITY:rirzn r- STATE: PHONE (DAYTIME): OWNER/BUILDER INFORMATION: NAME: CITY: PHONE (DA 0 ST. LUCIE CO CERT. #: _ ZIP: `19 FAX: C:;,q7 —R7 �( STATE: r2 ZIP: FAX: ARCHITECT/ENGINEER INFORMATION: NAME: -DAq o �°✓t .SS CA d/. ADDRESS: 11 Z CoLt�t w CITY: U(-/ crn a-A-✓i i STATE: _ PHONE (DAYTIME):( _-s 1.195' - /o y SLCCC: 9123109 Revised 06130/17 FAX: ZIP: