HomeMy WebLinkAboutAPPLICATION FOR PERMIT REVISIONOFFICE USE ONLY:
DATE FILED: _
REVISION FEE:
LOCATION/SITE
PERMIT# SLR y10?_ 073(7
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
MR
DETAILED DESCRIPTION OF PROJECT
CONTRACTOR INFORMATIION: �7 /
STATE of FL REG./CERT. #: C l9c D 16 Z Q
BUSINESS NAME: b (9 L l ✓U
QUALIFIERS NAME: O C FS PkIlIPPO
ADDRESS: _ 01 /3-1-Gv/ D
CITY: Ce STATE:
PHON (DAYTIME): 7? Z Z40 3 7
OWNER/BUILDER INFORMATION:
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ARCHITECT/ENGINEER INFORMATION:
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PHONE (DAYTIME):
SLCCC: 9123109
Revised 06130117
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ST. LUCIE CO CERT. #:
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1 EVIII
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ZIP: �?q 0-2
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