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HomeMy WebLinkAboutAPPROVED REVISION 11.17.20 OFFICE USE ONLY: DATE FILED: PERMIT# REVISION FEE: 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: a 2-1 "-k k c) :!)Y- \A- �-MCI 2 Ct 52 "' DETAILED DESCRIPTION OF PROJECT VISIONS 7 : - . c 7 \ mac...�s - &ii- �Sv ry-ve-+00 CONTRACTOR INFORMATION: STATE of FL REG./CERT. #: ( ST. LUCIE CO CERT. #: BUSINESS NAME: ' U-cC QUALIFIERS NAME: ne ene ADDRESS: Ll0 " � CITY: efcp, STATE: ZIP: ° + Q 2)' PHONE (DAYTIME): FAX: OWNER/BUILDER INFORMATION: NAME: ADDRES a CITY: L- STATE: t,_ ZIP: PHONE(DAYTIME C)qq FAX: ARCHITECT/ENGINEER INFORMATION: NAME: ADDRESS: CITY: STATE: ZIP: PHONE(DAYTIME): FAX: SLCCC: 9123109 Revised 06130/17