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APPLICATION FOR PERMIT REVISION
RECEIVED OFFICE USE ONLY: DATE FILED: _ REVISION FEE: 1. OCT 2 6 2017 Pew SIFM PLANNING & DEVELOPMENT SERVICES BUILDING & CODE REGULATION DIVISION 2300 VIRGINIA AVENUE FORT PIERCE, FL 34982-5652 (772) 462-1553 FAX (772) 462-1578 APPLICATION FOR BUILDING PERMIT REVISIONS PROJECT INFORMATION As�� ADDRESS: 47 TWIN CREEKS DRIVE ADDRESS: PERMIT# 1708-0598 2. DETAILED DESCRIPTION OF PROJECT REVISIONS: 3. 4. REVISION OF THE UNIT DESC. TIE DOWN 4 TON UNIT IOKW 17 SEER CONTRACTOR INFORMATION: STATE of FL REG./CERT. #: CAC058160 LMHO OnEERT. #: BUSINESS NAME:ALLY 11��111�� QUALIFIERS NAM, NE 4T ADDRESS: 1 �4 CITY: STATE: FE ZIP: 3330 PHONE (DAYTIME): - - FAX: OWNER/BUILDER INFORMATION: NAME: ADDRESS: CITY: PHONE: RUDY MORRIS 11 b4-fTWIN CREEKS DRIVE STATE: FL zIP: 3495 7724893041 FAX: 5. ARCHITECT/ENGINEER INFORMATION: NAME: ADDRESS: CITY: PHONE (DAYTIME): Revised 07/22/2014 STATE: FAX: ZIP: