HomeMy WebLinkAboutBuilding Permit RevisionsOFFICE USE ONLY:
DATE FILED: J
REVISION FEE:
PERMIT #
RECEIPT #
PLANNING- & DEVELOPMENT SERVICES
BUILDING & CODE REGULATION DIVISION RECEIVED
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652 NOV 12 2021
(772) 462-1553
fit: �9,q l�vo my
APPLICATION FOR BUILDING PERMIT REVISIONS
PROJECT INFORMATION
LOCATION/SITE
ADDRESS: `,� q ea v-[+ O n qZC ?5 L--
DETAILED DESCRIPTION OF PROJECT
REVISIONS:
Mc . (Ct4ck.-e r\ lv'►/lcl 0 w Or-)
Concre-+ 6 c- - I" o (v -C LAS X LJC�
CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #:
BUSINESS NAME:
QUALIFIERS NAME:
ADDRESS:
CITY:
PHONE (DAYTIME):
STATE:
OWNER/BUILDER INFORMATION:
NAME: 1-t k c--
ADDRESS: 3q V L
CITY: - i
PHONE (DAYTIME:
ARCHITECT/IENGINEER INFORMATION:
NAME: k, )� c AL t -Q
ADDRESS:
CITY:y 2 S 0
PHONE (DAYTIME):
SLCCC: 9123109
Revised 06130117
ST. LUCIE CO CERT. #:
ZIP:
FAX:.
It S�D d cro r d
c0?4w