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HomeMy WebLinkAboutREVISION 12-17-18OFFICE I DATE F11 REVISIO USE ONLY: XD: I �- 0 -19 RECEIVED PERIWIT # 0 3 '-/,3 2018 RECEIPT # L pllrtm,,,- DEC ,li FEE: 1 Permitting I St- PLANNING BUILDING & DEVELOPMENT S P - rl & CODE REGULATION D MANNED AAl 2300 VIRGINIA AVENU - FORT PIERCE, FL 34982 By SMucie County (772) 462-1553 APPLICATION FOR BUILDING PERMIT REON-F PROJECT INFORMATION LOCATION/SITE ADDRESS: 1115-20 61- 601 P/ O-JE7 Dcyt,,I, Q0. FLIA, DETAILED DESCRIPTION OF PROJECT REVISIONS: ®L Aq) /0-,//Iv p- F-A fe 5 Z?q�- jp- AE 1// '5 CONTRACTOR INFORMATION: STATE of FL REG./CERT. #: C R-d 611-35-3 P ST. LUCIE CO CERT. #: BUSINESS NAME: Cp/f L 02VYV-� 7'P-IJ 0- mey 14f."D 'W310a& we_ j 0TTAT.TF11RRRNAMF.- mR'p-m 410%;?1 ADDRESS: 2A 2�1: IdA CITY: STATE: PHONE (DAYTIME): -7 72- 24 0 -? 6� q FAX: OWNER/BUILDER INFORMATION NAME: 61 9&�� ADDRESS: CITY: PHONE (DAYTIME: ARCHITECT/ENGINEER NAME: /11--'� ADDRESS: CITY: PHONE (DAYTIME): SLCCC: 9123109 Revised 06130117 I STATE: I FAX: %IATION; STATE: FAX: ZIP: 3 997,1-2 ZIP: ZIP: -p fte COPY 4