HomeMy WebLinkAboutPermit 2006-0246 Revision FormOFFICE USE ONLY:
DATE FILED:
REVISION FEE:
LOCATION/SITE
ADDRESS:
PERMIT # Q-
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
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DETAILED DESCRIPTION OF PROJECT
REVISIONS:
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CONTRACTOR INFORMATION:
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STATE of FL REG,/CERT. #:G& G I .r l % Z,,� ST. LUCIE CO CERT. #: BUSINESS NAME: VD, .L►f+G
QUALIFIERS NAME: A "� - III
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ADDRESS: " lo-
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CITY: UeiLp STATE:
PHONE (DAYTIME): cl)g GpS�3. ZIP 32
FAX:
OWNER/BUILDER INFORMATION:
NAME: A"e4 4 LGJ
ADDRESS:_(�-� CA-*
CITY:
PHONE (IVVTF��
STATE: Z
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ARCHITECT/ENGINEER INFORMATION:
NAME: aw L Le 0.0A425
ADDRESS: 1 `7 I { '6A.--• Z r -vjo
CITY: c�.c.C, _ STATE: _
PHONE (DAYTIN4E):
SLCCC: 9: 23. 09
Revised 06 30 17
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