HomeMy WebLinkAboutRevisions; Accessory Building Remove Electric PermitOFFICE 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: .
1
DETAILED DESCRIPTION OF PROJECT
REVISIONS:, ,
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CONTRACTOR INFORMATION:
TZ
STATE of FL REG./CERT. #: ST. LUCIE CO CERT. #:
BUSINESS NAME: K
QUALIFIERS NAME: lyprL
ADDRESS: pl-
S W iAe!rCITY: �0r(,(-C,'Y— ATE: ZIP: 3 (N
PHONE (DAYTIME): FAX:
OWNER/BUILDER INFORMATION:
NAME:
ADDRI
CITY: 1
FAX:
ARCHITECT/ENGINEER INFORMATION:
NAME: 1' d lot {II� ,r S A &49&-,J�S
ADDRESS: 0Lo�i�
CITY: 940 if STATE: ZIP:
PHONE (DAYTIME): 9�a,9- FAX:
SLCCC: 9123109
Revised 06130/17