HomeMy WebLinkAboutREVISION FORM , ELECTRICAL i
OFFICE USE ONLY:
DATE FILED: I PERMIT# a
REVISION FEE: I RECEIPT#
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PLANNING&DEVELOPMENT SERVICES
BUILDING&CODE REGULATION DIVISION
2300 VIRGINIA AVENUE
j FORT PIERCE,FL 34982-5652
(772)462-1553
gpI?2 a APPLICATION FOR
INFORMATION
PERMIT REVISIONS
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S(,��n PROJECT
9 6�
N/SITE
ADDRESS:
3403-502-0166-000-8
3055 W Midway Rd, Fort Pierce, FI 34981
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DETAILED DESCRIPTION OF PROJECT
REVISIONS:
MASTER PERMIT#211.0-0358 Ravinia 3 LEFT-Electrical plan revised,move-dining light to 5'6'off the wall,no lift station
needed for project,disc removed,underground service for all jobs,kitchen laundry,bath fixtures
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CONTRACTOR INFORMATION:
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STATE of FL REG./CERT. #: CBC1254289 ST. LUCIE CO CERT. #:
BUSINESS NAME, I Synergy Homes,LLC
QUALIFIERS NAME:
ADDRESS: 581 NW MERCANTILE PL SUITE 106
CITY: PORT ST LUCIE STATE: FL ZIP: 34986
PHONE(DAYTIME): 954 557 9735 FAX:
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OWNER/BUILDER INFORMATION:
NAME: Synergy Ho i s,LLC
ADDRESS:581 NW MERCANTILE PL SUITE 106
CITY: PORT ST LUCIE STATE: FL ZIP: 34986
PHONE(DAYTIME: 954 557 9735 FAX: J
,i
ARCHITECT/ENGINEER INFORMATION:
NAME: LILLIAN GO IZALES
ADDRESS: 1824 RICHARD LANE
CITY: PALM SPRINGS STATE: FL ZIP: 33406
PHONE(DAYTIMIE): 561-294-s929 FAX:
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SLCCC: 9123109
Revised 06130/17