HomeMy WebLinkAboutApplication For Permit Revision 12-15-21;ECEIVED
OFFICE USE ONLY: DEC 15 202,
iA bs;l �� St. Lucie Do��ry
DATE FILED: pefmltting
REVISION FEE: (,. ► yoiLc
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LOCATION/SITE
PERMIT # � (V 7 ~ g O ,5
RECEIPT #
PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE REGULATION DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462.1553
APPLICATION FOR BUILDING PE I
PROJECT INFORMATION
DETAILED DESCRIPTION OF PROJECT
REVISIONS:
A,-.V •7- oh
3
CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #:
BUSINESS NAME:
QUALIFIERS NAME:
ADDRESS: J5.7— /V e L6h s r
CITY: ',� SA S STATE:
PHONE (DAYTIME): fig- �3 6
WNER/BUILDER INFORMATION:
NAME: J�� !� LJ 44b q
ADDRESS: 2 .Nc
CITY: �'or� s'� L�rC� STATE:
PHONE (DAYTIME: 772 S� S- y A36
ARCMTECT/ENGINEER INFORMATION:
NAME: P11-14
ST. LUCIE CO CERT. #:
ZIP: 1�7'? 5
FAX:
hz- ZIP:
FAX:
ADDRESS:
CITY: Rd- S f STATE: ZIP:
PHONE (DAYTIME): 7 79- - 78'5-- fl9V FAX:
SLCCC: 9123109
Revised 06130117