HomeMy WebLinkAboutRevisions OFFICE USE ONLY: f
DATE FILED: Z�-' �`" z^'I _ PERMIT#
REVISION FEE: ( J RECEIPT# 1-7- 1 1 n��
PLANNING &DEVELOPMENT SERVICES
BUILDING&CODE REGULATION DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652 RECEIVED
(772)462-1553 FEB 112021
APPLICATION FOR BUILDING PERMIT REVISIONS permitting Department
PROJECT INFORMATION St. Lucie County
LOCATION/SITE
ADDRESS:
-7S®_3 &4,,� ge/ Etoff e , FL 3 V 9,'>
DETAILED DESCRIPTION OF PROJECT
REVIS OWNS: 4t-5
fF�' GLL l v it Favl�l S a'V /fie 4l",
��G/r� G+ /11�' ✓ 1 / ►/ /�/` P�rr� ' ��<� i_�, 7(l rJP � 1 031 �7�1r nr/e
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: 3ic-/7
ADDRESS: dI 3 Jzr) e l7!:: 94
CITY: rq ����`C�� STATE: ZIP:
PHONE (DAYTIME: 41�2 0 A-,a 7,Z--Y.�/6 FAX:
ARCHITECT/ENGINEER INFORMATION:
NAME:
ADDRESS:
CITY: STATE: ZIP:
PHONE(DAYTIME): FAX:
SLCCC.• 9123109
Revised 06130/17
J
EVIS ON
19� 2(b r fv�n,
—�' REVIE' E® FOR
CODE C MPLIANCE
ST. LUC1 COUNTY
B cc
s
ov Sfax y C U� S
� esro���rce
' f i
Z 20
All (,-a y of PPS°�°�