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HomeMy WebLinkAboutRevision Deferred SubmitalOFFICE USE ONLY: DATE FILED: I f9z: REVISION FEE: PERMIT# RECEIPT # 114 RECEIVED PLANNING & DEVELOPMENT SERVICES BUILDING & CODE REGULATION DIVISION OCT 2 5 2Qil 2300 VIRGIMA AVENUE FORT PIERCE, FL 34982-5652 (772) 462-1553 FAX (772) 462-1578 PERMITTING . St. Lucie County, FL APPLICATION FOR BUILDING PERMIT REVISIONS 1. LOCATION/SITE "1,L�1"'l�r��t ADDRESS: iYl �J�,8�� Ph�T e2 ArtJ%i� 2. DETAILED DESCRIPTION OF PROJECT REVISIONS: 3. CONTRACTOR INFORMATION: STATE of FL REG./CERT. #: C/W-1 BUSINESS NAME:. . S QUALIFIERS NAME: ADDRESS: CITY: PHONE (DAYTIME): 4. OWNER/BUILDER INFORMATION: NAME: A41) L ADDRESS: CITY: PHONE: 4 ARCHITECT/ENGINEER INFORMATION: NAME: ADDRESS: CITY: PHONE (DAYTIME): Revised 07/=014 ST. LUCIE COUNTY CERT. #: STATE: FAX: STATE: FAX: STATE: FAX: ZIP: ZIP: ZIP: a `" REVISION