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HomeMy WebLinkAboutAPPLICATION FOR PERMIT REVISIONSOFFICE USE ONLY: DATE FILED: REVISION FEE: q S ' V o PERMIT # I (eD Z- 0 b Z RECEIPT # PLANNING & DEVELOPMENT SERVICES BUILDING & CODE REGULATION DIVISION 2300 VIRGINIA AVENUE FORT PIERCE, FL 34982-5652 (772) 4624553 APPLICATION FOR BUILDING?R�RMIT REVISIONS PROJECT INFORMATION LOCATION/SITE 3 ADDRESS: Q o.5 i�i verb P1oew 1=+t Piernf R :34 igrz DETAILED DESCRIPTION OF PROJECT REVISIONS: Z&ZA I L CONTRACTOR INFORMATION: STATE ofFL REG./CERT. #: t 5200U0 ST. LUCIE CO CERT. #: BUSINESS NAME: 2 Q . ? eVe�i • QUALIFIERS NAME nnt5 W f r© w ADDRESS: Z346 (LFtft A -ye- *- CITY: I -eVo i3eacO STATE: F-1 PHONE (DAYTIME): r1172 Ni - f74 99 FAX: OMTMVBUIELDER INFORMATION: NAME: ADDRESS: CITY: PHONE (DAYTIME: STATE: ARCHITECT/ENGINEER INFORMATION: NAME: �hauI val ADD (3 CITY: '/+• We - PHONE (DAYTIME): r7 r7: SLCCC: 9123109 Revised 06130117 la V2 STATE: PAX: ZIP: , 22&-0 ZIP: ZIP: File COpy