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HomeMy WebLinkAboutBuilding Permit Application RevisionOFFICE USE ONLY: �l 7 DATE FILED: PERMIT # REVISION FEE:' W RECEIPT # G 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 LOCATION/SITE DETAILED DESCRIPTION OF PROTECT 'D'V -%7yC TnlVQ . - :Fxr Z7 7-A446- s 6Ao0' 7P rO / 6 ' CONTRACTOR INFORMATION: STATE of FL REG./CERT. #: ST. LUCIE CO CERT. 9: BUSINESS NAME: &ADZ jn .,l J i4 /'lg2.ly42 TS QUALIFIERS NAME: ADDRESS:PC) - CITY: -))(-9 50IU STATE: A/4!Z— ZIP: 2ZDI PHONE (DAYTIME): / " ODU fl20t:_W4.,Z FAX: 641�.�/ OWNER/BUILDER INFORMATION: NAME: ADDRESS:/mil i�2 �/L�T�.�`-►�_L�vti�1 CITY: 7-- p16�C('LF: STATE: 9:4.— ZIP: PHONE (DAYTIME: �6Z t — � � ma y . FAX: N/fit ARCHITECT/ENGINEER INFORMATION: NAME: Twk ADDRESSVr� 2 CITY: ',n,/?-& /� STATE: �L. ZIP: PHONE (DAYTIME): FAX: SLCCC: 9123109 Revised 06/30/17 I^N File Copy