HomeMy WebLinkAboutREVISION FORM (2)OFFICE USE ONLY.
DATE FILED: PERMIT # 2011-0229
REVISION FEE. RECEIPT #
PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE REGULATION DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 2-5652
(77) 462.1553
APPLICATION FOR BUILDING PERMIT REVISIONS
PROJECT INFORMATION
LOCATION/SITE
ADDRESS:
10210 Carlton Road, Fort Pierce, FL 34987
DETAILED ESC IPTI N OF PROJECT
REVISIONS:
Changed truss company due to production
CONTRACTOR INFORMATION:
STATE of FL REG.ICE,RT, #: CGC1524734 ST. LUCIE CO CERT. #:
BUSINESS NAME: Groza Builders,lnc,
QUALIFIERS NAME: John A. Groza
ADDRESS: 511 SW PSL Blvd.
CITY: PSL. STATE: FL ZIP: 34953
PHONE (DAYTIME): ,772-336-7653 FAX
OWNER/BUILDERINFORMATION:
NAME: George & Angela Martire
ADDRESS-1711 SE Carvahlo Street
CITY: PSL STATE: FL ZIP: 34983
PHONE (DAYTIME: 772-643-3699 FAX:
ARCHITECT/ENGINEER INFORMATION:
NAME: Christopher D. Beers
ADDRESS: 5109 Grand Palmetto Way
CITY: North Port STATE: FI ZIP: 34291
PHONE (DAYTIME): 941-628-0635 FAX:
SLC"C'C: 9123109
Revised 06130117