HomeMy WebLinkAboutRevisionOFFICE USE ONLY:
DATE FILED: _
REVISION FEE:
PERMIT # j C-- /V��oc2
RECEIPT #
PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE REGULATION DIVISION
2300 VIRGINIA AVENUE RECEIVED
FORT PIERCE, FL 34982.5652
(772) 462.1553 MAR 2 9 2022
St. Lucie County
APPLICATION FOR BUILDING PERMIT REVISIONS Permitting
PROJECT INFORMATION
LOCATION/SITE
ADDRESS:
?34
FDQ F uJ/EACH 6� -
DETAILED DESCRIPTION OF PROJECT
REVISIONS:
—� ) 7i. I/
y tO/ oiu OF hF14C- f 6TOlD .
CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #:
BUSINESS NAME:
QUALIFIERS NAME:
ADDRESS:
CITY:
PHONE (DAYTIME):
STATE:
OWNERBUILDER INFORMATION:
NAME: I /nA 7,C7i (� , [ , L -7-,=
ST. LUCIE CO CERT. #:
FAX:
CITY: _ �C RT Pjh'L STATE: ��
PHONE (DAYTIME: — 6 r,-t/ FAX:
ARCHITECT/ENGINEER INFORMATION:
NAME:_ /J,9CdL 1w-=LCi-1 -�t/1)
ADDRESS: cf ILTM a R E S 77 je
CITY: J STATE:
PHONE (DAYTIME):I per:
SLCCC: 9123109
Revised 06130117
PA
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ZIP:
ZIP:
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