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HomeMy WebLinkAboutAPPROVED Survey, revised, contractor copyOFFICE USE ONLY: DATE FILED: Al REVISION FEE: LOCATION/SITE PERMIT # C-) 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 ADDRESS: � � a �� ,�o ��.- fs !�'�J _ ve,'rre- e— oV. —3 IY7 DETAILED DESCRIPTION OF PROJECT REVISIONS: . If CONTRACTOR INFORMATION: STATE of FL REG./CERT. 9: ST. LUCIE CO CERT. 9: BUSINESS NAME: /,a-< 4 X QUALIFIERS NAME: ---j +e- r /5 ADDRESS: `7 e,,, AL4,0 [,-- CITY: - pop t _fy. /,, e A� - STATE: — - A / — ZIP: PHONE (DAYTIME):-7 -7,4 - 3 Vy - Ad IV Is— FAX: OWNER/BUILDER INFORMATION: NAME: ADDRESS: CITY: PHONE (DAYTIME: STATE: ARCHITECT/ENGINEER INFORMATION: NAME: ADDRESS: CITY: PHONE (DAYTIME): SLCCC ' -9123109 Revised 06130117 ZIP: FAX: STATE: ZIP: FAX: „�1� TNt�i>4Af R L tlE tj rENc[ Scet'r l �f-c,r s ��0 5cv �5►,;,o so r31 vcl. (77��3Y�-loYj I-017c, 7&D S Re be. 71s F7- Pi ur 30.;1©f 7 �.' �h�;n 4:hK l tnGe- wit -A /P�/li�1�c GurcaAd 1 "ib`�✓�odt Qe,% J CONTRACTOR COPY MIN. SETBACK REQ. FRONT SIDES CNR SIDES REAR ZNG. TECH. 5�� err oZl('�j-(>SUi