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REVISION 5-22-18
OFFICE USE ONLY: I (� DATE FILED: Ste- 22' ly REVISION FEE: -7 'Op SGANNEL �4 Lucia County PERMIT # / g��+�� RECEIPT # 32 So q ` 40 �.�LANNING & DEVELOPMENT SERVICES a �y ti � ILI, t' BUILDING & CODE REGULATION DIVISIONy, y Y' '-`� . � � r �; • �.g � �• � 2300 VIRGINIA AVENUE FORT PIERCE, FL 34982-5652 RECEIVED (772) 462.1553 MAY 12 101g APPLICATION FOR BUILDING PERMIT REVISIONS Permitting oepatm PROJECT INFORMATION St. Lue Coun v LOCATION/SITE ♦ TTTiTOC_ � � DETAILED DESCRIPTION OF PROJECT REVISIONS: ,�r l �N / s , _ CONTRACTOR INFORMATION: STATE of FL REG./CERT. BUSINESS NAME: QUALIFIERS NAME: ' ADDRESS: CITY: STATE: PHONE ( AYTIME): OWNER/BUILDER INFORMATION: �'NAME: ADDRE; CITY: PHONE (DAYTIME: ARCHITECT/ENGINEER INFORMATION: NAME: ADDRESS - CITY: PHONE (DAYTIME): SLCCC: 9123109 Revised 06130117 >T—LU_Q.IE C RT. #; ZIP: FAX: FAX: