HomeMy WebLinkAboutP#2010-0232 Revision sheetOFFICE USE ONLY:
DATE FILED: -
REVISION FEE:
1. LOCATION/SIT
ADDRESS. a
2.
3.
4.
PERMIT #
RECEIPT #
PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE REGULATION DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553 FAX (772) 462-1578
APPLICATION FOR BUILDING PERMIT REVISIONS
PROJECT INFORMATION
v
DETAILED DESCRIPTION OF PROJECT
CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #: RK I t o (M N ST. LUCIE COUNTY CERT. #:
BUSINESS NAME: pko"Em 5Cz2r`ei-j cv . 2r do . m-
QUALIFIERS NAME: M i e H a;= L t4 Ewl M R
ADDRESS: 168Z. SW 131LTMokC ST.
CITY: pocr St. tug t STATE:
PHONE (DAYTIME): 1m) 3'Lt0 —c13g3 FAX:
OWNER/BUILDER INFORMATION:
NAME:
ADDRESS:
CITY:
PHONE:
Llr763
- ZIP: 3 `19 irl
TZ� �40162G
5. ARCHITECT/ENGINEER INFORMATION:
NAME: DO w1k + Assoc.
ADDRESS: PO. r6o-x10039
CITY: A M FA STATE: 1= L ZIP: 33 6Z
PHONE (DAYTIME)_ &69 5- 9 q 55 FAX:
Revised 07/22/2014