HomeMy WebLinkAboutSLC Deferral Permit - Roofing only # 201-0339OFFICE USE ONLY:
DATE FILED:
REVISION FEE:
PERMIT # 90 1" Q 3 3 91
RECEIPT #
PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE REGULATION DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
APPLICATION FOR BUILDING PERMIT DEFERRALCAodPiw%PROJECT INFORMATION LOCATION/SITE
ADDRESS: AY30 Nolole< Oaks L.oLne — Lot �!
r r c. a '" L. .3 1 `I S
DETAILED DESCRIPTION OF PROJECT
REVISIONS:
A c'_ontracinr haA nod- be -co sCleo+ed a-f
I n 1 h I I rm c- . w c- w V n a !m6C c- u" n c. r- cu r .t .,-; r 8,76 u. a s -acwz - i- .
We'6- like. Newe to secoc-e, m0004 c-oo-�ec cAl"t+h CAVailibi�, T-0
CONTRACTOR INFORMATION: co ✓h ID l tfr- - (iob • IAv o ti e f 5
STATE of FL REG./CERT. #:
BUSINESS NAME: C O&&*yC`
QUALIFIERS NAME: _ P. lQu c,(
ADDRESS: /ya.� i! c�-
�c.ct ce,P�
CITY: po-t W. 1..y Gi t S`TATE: _rj
PHONE (DAYTINIE):(2��•2 (�I ~ 3�al 6-3—
ENS UILDER INFORMATION:
NAME: io Aure-fa �1 GLI'1 Ct
� pe,re� �
So -t-a r to ek i i
ST. LUCIE CO CERT. #:
ADDRESS: y56 NV t!!�Gt.Ve&IS r,J-Dod- L,ccn f,
CITY: port- S f., J. o C i z STATE: Pl—
PHONE (DAYTIME: (9-17.t FAX: _
ARCHITECT/ENGINEER INFORMATION:
NAME: vrorl7,o riao,5
ADDRESS: E N4fc�rtn' G al t'-
CITY: p� ram- S7. 1� u C, i G STATE:
PHONE (DAYTIME):
SLCCC: 9123109
Revised 07117118
FAX: