HomeMy WebLinkAboutREVISION 6-15-18OFFICE USE ONLY:
BY
DATE FILED: ` `� ' I (� St Lucie CountyPERMIT # I �n��q
REVISION FEE: RECEIPT #
PLANNING & DEVELOPMENT SERVICES RECEIVED
BUILDING & CODE REGULATION DIVISION
2300 VIRGINIA AVENUE JUN 15 202
FORT PIERCE, FL 34982-5652
(772) 462.1553 ST. Lucie county, Permitting
APPLICATION FOR BUILDING PERMIT REVISIONS
PROJECT INFORMATION
LOCATION/SITE
DETAILED DESCRIPTION OF PROJECT
REVISIONS:
GNuw�Y�S flUr1T`y�tit�ri`�.� (Y'ov✓f SGt/i�t�`cS TO !/ilr�l
CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #:
BUSINESS NAME:
QUALIFIERS NAME:
ADDRESS:
CITY:
PHONE (DAYTIME):
STATE:
OWNER/BUILDER INFORMATION:
NAME: _
ADDRESS:
CITY:
PHONE (D,
ARCHITECT/ENGINEER INFORMATION:
NAME:au
ST. LUCIE CO CERT. #:
FAX:
ADDRESS: S 0 16;It-ro-rr, 5-- s 11
CITY: +R'• L STATE: F L
PHONE (DAYTIME): % a., 7 9"o5 FAX:
ZIP:
ZIP:
SLCCC: 9123109
Revised 06130/17
==CO REVISION