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Home My WebLink AboutAPPROVED REVISION FORM, R1 POWERS REVISION FORMOFFICE USE ONLY: 117r11322114011T REVISION FEE: PERMIT # RECEIPT # PLANNING & DEVELOPMENT SERVICES BUILDING & CODE REGULATION DIVISION 2300 VIRGINIA AVENUE FORT PIERCE, FL 34982-5652 (772) 462-1553 APPLICATION FOR BUILDING PERMIT REVISIONS PROJECT INFORMATION LOCATIONISITE ADDRESS: 9// ✓t��,rsor� �/� DETAILED DESCRIPTION OF PROJECT REVISIONS: Q e/2 ei7, CONTRACTOR INFORMATION: STATE of FL REG./CERT. 9: C'�C ��✓�lf(D7 BUSINESS NAME: d QUALIFIERS NAME: ADDRESS. S E CITY: _ �� STATE: PHONE (DAYTIME): WN BUILDER INFORMATION: NAME- ADDRESS: - CITY: ze�- f PHONE (DAYTIME: ARCHITECT/ENGINEER INFORMATION: NAME: , /'PO ADDRESS: a CITY: STATE: PHONE (DAYTIME): r%2 SLCCC: 9123109 Revised 06130/17 ST. LUCIE CO CERT. #: ZIP: c FAX: 1% � • �i/i FAX. ZIP:y982.