HomeMy WebLinkAboutRevisions; Energy CodesOFFICE USE ONLY:
DATE FILED: a a 1
REVISION FEE:
RECEIVED FEB 10 7017
PERMIT # \(D O1 ^ O
RECEIPT # a i C
PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE REGULATION DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553 FAX (772) 462-1578
APPLICATION FOR BUILDING PERMIT REVISIONS
PROJECT INFORMATION
1. LOCATION/SITE n n I
ADDRESS: 11172 094t r- A r
2. DETAILED DESCRIPTION OF PROJECT
REVISIONS:
��VISFO eNr-17 CAICU(10M 3r,5
3. CONTRACTOR INFORMATION: flEvIslum
STATE of FL REG./CERT. #: ST. LUCIE COUNTY CERT. #:
BUSINESS NAME: e�o
QUALIFIERS NAME: G s
ADDRESS: Z30`zjTL-9171/la AVrz
CITY: 0rt(,AT-00 STATE: ZIP: I
PHONE (DAYTIME): -7-12 , 5 7 9 . SS 3 FAX:
4. OWNERBUILDER INFORMATION: -
NAME: u r
ADDRESS: Flaw"m
CITY: STATE: ZIP:
PHONE: FAX:
5. ARCHITECT/ENGINEER INFORMATION:
NAME:
ADDRESS:
CITY:
PHONE (DAYTIME):
Revised 07/22/2014
STATE:
FAX:
ZIP: