HomeMy WebLinkAboutAPPLICATION FOR PERMIT RENEWALOFFICE USE ONLY:
DATE FILED:
PERMIT
REVISION FEE: — RECEIPT #
PLANNING & DEVELOPMENT SER I VICES
BUILDING & CODE REGULATION DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-565
(772) 462-1553
APPLICATION FOR BUILDING PERMIT EVISIONS
PROJECT INFORMATION
LOCATION/SITE
ADDRESS:.
DETAILED DESCRIPTION OF PROJECT
REVISI�N: riot
2 h� cy E r a
CONTRACTOR INFORMATION:
'I i
' 0�b t 1 V
STATE of FL REG./C:ERI['. #: ST. LUCE CO CERT. #:
BUSINESS NAME: —�- -T
QUALIFIERS �ME: — -- --
ADDRESA-It
CITY: �PHON
OWN]
DAME
ADDR
CITY:
PHON
ARCH
NAME
ADDR
CITY
STATE: ZP:
PHONE (DAYTIME):
SLCCC: 9/23/09
Revised 06/30/17
J11AIr:
FAX: