HomeMy WebLinkAboutBuilding Permit RevisionOFFICE USE ONLY:
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REVISION FEE: '�..
PERMIT #
RECEIPT #
PLANNING & DEVELOPMENT SERVICES RECEIVED
BUILDING & CODE REGULATION DIVISION
2300 VIRGINIA AVENUE SEP 0 2 2021
T']-(%l: A NGe,c,n, FORT PIERCE, FL 34982-5652
(772) 462-1553 St Lucie RaLjnty
Permitting
APPLICATION FOR BUILDING PERMIT REVISIONS
PROJECT INFORMATION
LOCATION/SITE
ADDRESS:
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- 0(301L
DETAILED DESCRIPTION OF PROJECT
RE ISIONS:
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CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #:
BUSINESS NAME:
QUALIFIERS NAME:
ADDRESS:
CITY:
PHONE (DAYTIME):
STATE:
OWNER/BUILDER INFORMATION:
NAME: LLrzli IrJ SuLC-I„A,J
ST. LUCIE CO CERT. #:
FAX:
ZIP:
ADDRESS: -5-0G c) S Lf4-S A of. -'a r&4 , L—
CITY: FF STATE: r— — ZIP: 3�1,9r
PHONE (DAYTIME: 9,�`► G S k- k-3-. FAX:
ARCHITECT/ENGINEER INFORMATION: File Copy
NAME:
ADDRESS:
CITY:
PHONE (DAYTIME):
SLCCC: 9123109
Revised 06130/17
STATE:
FAX:
ZIP: