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REVISION 3-19-19
OFFICE USTI ; ONLY: SCANNED 2 DATE FILED: J -19 -19 DIV REVISION FEE: �h. ®d PERMIT # _ I 03 ' © (Q ZS RECEIPT # I �A OBI 5EHI PLANNING & DEVELOPMENT SERVICES BUILDING & CODE REGULATION DIVISION _ 2300 VIRGINIA AVENUE RECEIVED FORT PIERCE, FL 34982.5652 I(772) 462.1553 MAR 19 2019 FILE COPY APPLICATION FOR BUILDING PERMIT REVISIOt SST, Lucie w, ,e ounty, Permitting PROJECT INFORMATION LOCATION/SITE ADDRESS: DETAILED DESCRIPTION OF PROJECT REVISIONS: SN C'N�a'5 e s i_ 2 �llr&VA /2 x/ 2 4.6 l 2 x 2 i CONTRACTOR INFORMATION: STATE -of FL REG./CERT. #: QK2 r2S'///3 z BUSINESS NAME: QUALIFIERS NAME: doh ADDRESS: CITY: STATE: / PHONE (DAYTIME): 772_370 ^Je/-rr OWNER/BUILDER INFORMATION: NAME:�f%-� ADDRESS: CITY: .L PHONE (DAYTIME: -9 ST. LUCIE CO CERT. #: )r-In-')Llovn )-.A e- ZIP: 9 _,61;2� FAX: -27:2—,j2e7-373y STATE: it / ZIP: 3 z-19 isz FAX: ARCHITECT/ENGINEER INFORMATION: NAME: ADDRESS: CITY: STATE: _ PHONE (DAYTIME): SLCCC: 9123109 Revised 06130/17 ZIP: FAX: REVISION 4 2- .31/1 m MIN..SETBAC FRONT - SIDES CNRSIDES. -'---- CONTMUMC � I wFILE COPY REQ.