Loading...
HomeMy WebLinkAboutREVISIONOFFICE USE ONLY: DATE FILED: REVISION FEE: .5� PERMIT # J —71a - 6 V6S RECEIPT # PLANNING & DEVELOPMENT SERVICES BUILDING & CODE REGULATION DMSION 2300 VIRGINIA AVENUE FORT PIERCE, FL 34982-5652 (772) 462-1553 FAX (772) 462-1578 APPLICATION FOR BUILDING PERMIT REVISIONS PROJECT INFORMATION I. LOCATION/SITE ADDRESS: 3bH--1 U3mS)5l-tl4AAC 2. DETAILED DESCRIPTION OF PROJECT REVISIONS: c" ?-I, " 1 3 5 bar- C c L o v� ✓� c��0a 3. 4. CONTRACTOR INFORMATION: STATE of FL REG./CERT. #:('g,G I ���� ST. LUCIE COUNTY CERT. #: BUSINESS NAME: QUALIFIERS NAME: ADDRESS: CITY: STATE: ZIP: PHONE (DAYTIME): FAX: OWNER/BUILDER INFORMATION: NAME: ADDRESS: CITY: PHONE: 5. ARCHITECT/ENGINEER INFORMATION: NAME: ADDRESS: CITY: PHONE (DAYTIME): STATE: STATE: FAX: Revised 07/22/2014 RECEIVED - ' FEB. artmen permlttln9 DePCount" �h St, Luce FAX: ZIP: ZIP: