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HomeMy WebLinkAboutAPPLICATION FOR PERMIT RENEWAL 7-11-17 (2)OFFICE USE ONLY: SCANNED 0 V DAU MERE:- PERMIT # Sib REVISIONFEE: RECEIPT # 1. LOCATION(SITE ADDRESS: 0 3. 4. 5. -4- PLANNING & DEVELOPMENT SERVICES BUILDING & CODE REGULATION DIVISION AL 1 2�00 VIRGMA AVENUE F PIERCE, FL 300-5652 PERWI (772)462-1553 St. Lucie Couniy, FL: APPLICATION FOR BUILDING PERMIT REVISIONS PROJECT INFORMATION DETAILED DESCRIPTION OF PROJECT REVISIONS: r.4 -I � Wffl A U/ CONTRACTOR INFORMATION: STATE of FL REG./CERT. #. BUSINESSNAME: PA a I ST. �UCIE COUNTY CERT. 6 QUALEFIERS NAME: ADDRESS: ex $. bv�'. C,. 41 CITY: 6ilel STAT 44' W17-41 9: ZIP: PHONE (DAYTIME): FAX: 6, Z- YO 6, OWNERMUELDERINFORMATION: NAMEr ADDRESS: LTE: ZIP: CITY- ST) PHONE: FAX: ARCHITECT/ENGINEERINFORMATTON: NAME: ADDRESS: ZIP: CITY STATE: PHONE (DAYTIME): FAX: SLCCQ 9/23109 Revised 04t2612010 �6 7