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Home My WebLink AboutRevisions j ,I ,OFFICE USE ONLY: J DATE FILED: / �' l PERMIT# �/ �^ ©e�', / REVISION FEE: °' © (� RECEIPT# i PLANNING &DEVELOPMENT SERVICES BUILDING&CODE REGULATION DIVISION =-• 2300 VIRGINIA AVEN a �" ; '' "• , _FORT PIERCE FL 349 x t � ' 82- k,.,i'V1k 'i i c .•S (772)462-1553 9 APPLICATION FOR BUILDING PERM ` f r'V.PROJECT INFORMATION � 3 " LOCATION/SITE ADDRESS: DETAILED DESCRIPTION OF PROTECT REVISI S: / I CONTRACTOR INFORMATION: STATE of FL REG./CE T.#: jl ST. LUCIE CO CERT. #: BUSINESS NAME: QUALIFIERS NAME: ADDRESS: r I CITY: ATE: / ZIP: �I PHONE (DAYTIME): ' n FAX:. lj OWNEWBUILDER INFORMATION: Ij ll NAME: ij ADDRESS: CITY: STATE: � ZIP: IPHONE (DAYTIME: FAX: ARCHITECT/ENGINEER INFORMATION- NAME: 2 S)0�' ADDRESS: E CITY: STATE: ZIP: PHONE (DA T ME): FAX: SLCCC: 9123109 RECEIVED RE VISIO Revised 06130117 NOV 0 2-201?1 St.Lucie courn Perm+' FILE COPY