HomeMy WebLinkAboutREVISIONOFFICE USE ONLY:
DATE FILED: S\%i
REVISION FEE: -1
SCANNED
BY
St Lucie CcR.c*
PERMIT # Vt a. - 4 O
RECEIPT # 7 y o4
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
I. LOCATION/SITE
ADDRESS: 54 (� -S l K e e- TO F
Fr T iEw_cL< , F7L 3y951
2. DETAILED DESCRIPTION OF PROJECT
REVISIONS:
AvptrJG 4Sl�<gZf To "FOOL E)ICLOSuR.t� RiaHT SIPE
3. CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #: PX I IO (0 (9 l ST. LUCIE COUNTY CERT. #: U 63
BUSINESS NAME: P to 1jr-mz 5 Ct2 tre►J co . MN c, .
QUALIFIERS NAME: M t co ftr<L. IV EV J AAA-N
ADDRESS: 16 $2 SW 13ILTMoRt: ST aw
CITY: polcr Sr. w c l tr STATE: ZIP: 34 4
PHONE (DAYTIME): 34y -9393 FAX: T ) 340- 962(e
4. OWNER/BUILDER INFORMATION:
NAME:
ADDRESS:
CITY: STATE:
PHONE: FAX:
5. ARCHITECT/ENGINEER INFORMATION:
ZIP:
NAME: "DO K INS 4- ASSOC.
ADDRESS: PO. 6OX 10039
CITY: 7AIMPA STATE: r-(. ZIP: 336'7q
PHONE (DAYTIME): 313= 8 rl 5 9 9 5 FAX:
Revised 07/22/2014
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