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HomeMy WebLinkAboutRevisions OFFICE USE ONLY: DATE FILED: PERMIT# .�7c A—pt�7�j REVISION FEE: Oa- RECEIPT# PLANNING & DEVELOPMENT SERVICES BUILDING&CODE REGULATION DIVISION ' 2300 VIRGINIA AVENUE FORT PIERCE,FL 34982.5652 RECEIVED (772)462-1553 APPLICATION FOR BUILDING PERMIT REVISIONS DEC 0 7 2021 PROJECT INFORMATION St.Lucie County Permitting LOCATION/SITE ADDRESS: 96CC DETAILED DESCRIPTION,OF PROJECT REVISIONS:Gam✓ R6Juc�- Wr©LIAC 2o �A r vU� r-S A� M1�o0s AA4 MP-+o,.Lo®i'- CONTRACTOR INFORMATION: STATE of FL REG./CERT. #: CG'C /,,31 f r^ " ` ST. LUCIE CO CERT. _ #: BUSINESS NAME: u dilme) �o C�p f- QUALIFIERS NAME: ADDRESS: pj f 4- a!' CITY: (,for f- fi f,:���� STATE: 3qQ g9 ZIP: PHONE (DAYTIME): rzGI-,f ,e 53 r,. FAX: OWNER/BUILDER INFORMATION: NAME: `a 4(p 1 FO C!-� ADDRESS: M5© bri©C'�S.'��1`#' R,& CITY: For+ PLaerce STATE: ZIP: PHONE (DAYTIME:77)-- atl'o 3G FAX: ARCHITECT/ENGINEER INFORMATION: NAME: Be,r ao'r J o ne !S li ADDRESS:CITY: STATE:STATE: ZIP: PHONE (DAYTIME): r' FAX: z SLCCC: 9123109 f. Revised D6130/17 ti b