HomeMy WebLinkAboutREVISION0FFICE USE ONLY: SCANNED
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DATE FILED: c7' . R - �� Luci �'l��@��ei` PERMIT # 00
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REVISION FEE: 47S.00 I RECEIPT # 1 a
PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE REG',ULATION DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982.5652
(772) 462.1553
APPLICATION FOR BUILDING PERMIT I
PROJECT INFORMATION
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LOCATION/SITE
ADDRESS:
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DETAILED DESCRIPTION OF PROJECT
REVISIONS:Ch
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CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #:
BUSINESS NAME:
QUALIFIERS NAME:
ADDRESS:
CITY:STATE:
PHONE (DAYTIME):Cn;S)ULp5 --1w1n
OWNER/BUILDER INFORMATION:
NAME:
ADDRESS:
CITY: STATE:
PHONE (DAYTIME:
ARCHITECT/ENGINEER INFORMATION:
NAME:
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CITY: STATE:
PHONE (DAYTIME): - - -- -
FILE COPY
ST. LUCIE CO CERT. #: 2Ea09
FAX:
FAX:
SLCCC: 9123109
Revised 06130117
ZIP:
ZIP:
ZIP:
RECE D
MAY 0 7 2019
Pertrnitting Department
i St. Lucie COuntY� FL
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