HomeMy WebLinkAboutRevision 6-29-1800
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OFFICE USE ONLY:
DATE FILED: Ian • L�
REVISION FEE:
PERMrr # / 7 O S - 01 (e 3
RECEIPT #
PLANNING & DEVELOPMENT SERVICI
BUILDING & CODE REGULATION DIVISION
OPI
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982.5652
(772) 462.1553
APPLICATION FOR BUILDING PERMIT REVIS
PROJECTINFORMATION
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RECEIVED
JUN 2 9 2018
ST. Lucie County, Permitting
LOCATION/SITE aT/ r g / G3
ADDRESS:
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CONTRACTOR INFORMATION: ,
STATE of FL REG./CERT. #:
BUSINESS NAME:. G
QUALIFIERS NAME: Dkgbl
ADDRESS:35 G
CITY: �ALIA tiN' STA
PHONE (DAYTIME): TA - �294 '
OWNER/BUILDER INFORMATION:
NAME: -p;IME'A/i X 1S ALT
ADDRESS. /4 o 14. M Qr jXg3.c�
CITY: W EST eALA, 6EAC H STATE:
PHONE (DAYTIME: gl / - '�79 9 - DC7
ARCS ITECT/ENGINEER INFORMATION:
NAME:
ADDRESS:
CITY:
PHONE (DAYTIME):
ST. LUCIE CO CERT. #:
FAX:
= L ZIP:
FAX:
STATE: ZIP:
FAX:
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SLCCC: 9123109
Revised 06/30/17 "Evolum
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