HomeMy WebLinkAboutapproved REVISION FORM (2)OFFICE USE ONLY:
DATE FILED:
REVISION FEE:
LOCATION/SITE
ADDRESS:
Fort Pierce, FL 34982
PERMIT #
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
DETAILED DESCRIPTION OF PROJECT
REVISIONS:
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CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #: CGC1524734
BUSINESS NAME: Groza Builders, Inc.
QUALIFIERS NAME: John A. Groza
ADDRESS: 511 SW PSL Blvd
CITY: Port Saint Lucie STATE: FL
PHONE (DAYTIME): 772-336-7653
OWNER/BUILDER INFORMATION:
ST. LUCIE CO CERT. #: 16814
NEW4
ZIP: 34953
NAME: (tea-,-tc s o-.4
ADDRESS SSra I S�-Z
CITY: STATE: FL ZIP: _z4 Tq0
PHONE (DAYTIME 'lam-�(g„ �{ FAX:
ARCHITECT/ENGINEER INFORMATION:
NAME: Chris D. Beers
ADDRESS: 519 Grand Palmetto Way
CITY: Northport
PHONE (DAYTIME): 941-628-0635
SLCCC: 9123109
Revised 06130117
STATE: FL
FAX:
ZIP: 34291