HomeMy WebLinkAboutBuilding Permit Application DEFERRALOFFICE USE ONLY:
2109-0533
DATE FILED:
REVISION FEE: o.00 No Fee
PERMIT # 2109-0533
RECEIPT #
PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE REGULATION DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462.1553
APPLICATION FOR BUILDING PERMIT DEFERRAL
PROJECT INFORMATION
LOCATION/SITE
ADDRESS:
8304 SALERNO RD , FORT PIERCE, FL 34951
DETAILED DESCRIPTION OF PROJECT
REVISIONS:
Submitting truss layout and cut sheets
CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #:
BUSINEi SS NAME: ST LUCIE HABITAT FOR HUMANITY INC
QUALIFIERS NAME:
ADDRESS: 702 S 6TH ST
CITY: FORT PIERCE STATE: FI
PHONE (DAYTIME): (772) 464-1117
OWNER/BUILDER INFORMATION:
NAME:
ADDRESS:
CITY:
PHONE (DAYTIME:
STATE:
ARCHITECT/ENGINEER INFORMATION:
NAME: Ryan M. Bays
ADDRESS: 4451 St Lucie Blvd. Suite 201
CITY: Fort Pierce
PHONE (DAYTIME):
SLCCC: 9123109
Revised 07/17118
STATE: FI
ST. LUCIE CO CERT. #:
ZIP: 34950
FAX:
ZIP:
r Ax:
ZIP: 3494s
FAX: aw