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REVISION 1-23-19
Job ro OFFICE USE ONLY: DATE FILED: REVISION FEE:— L'S lb !j f LOCATION/SITE ADDRESS: - DETAILED DESCRIPTION OF REVISIONS: MAC e4k . I I I .SCANNED BY St Wele Cwtv CONTRACTOR INFORMATION: PERMIT # RECEIPT # ,I & DEVELOPMENT SERVICES RECEIVED 4 CODE REGULATION DIVISION 2300 VIRGINIA AVENUE JAN 23 '2019 FORT PIERCE, FL 34982-5652 (772) 462-1553 ST. Lucie County,.R!Lr_mml_l_l9j ATION -FOR BUILDING PERMIT REVISIONS PROJECT INFORMATION - STATE of FLREG./CERT. #: LfEC-62-,.4-3Z, ST. LUCIE CO CERT. #: BUSINESS NAME: QUALIFIERS NAME: *,-3;, 2 ADDRESS: (" &C (�o t•e., CITY:. .�",Q, k--rc 'STATE: PHONE (D_AY`tiME):. 51-6 —7 FAX: OWNER/BUILDERINFORMAI'lON: NAME: ADDRESS: I CITY: STATE: PHONE (DAYTIME: ARCHITECT/ENGINEER INFORMATION: NAME: llo,(r6 tl-e- I ADDRESS: jJ5 / (,4*4c CITY: p STATE: PHONE (fMYTIME): L6Z ZLf3 — SLCCC.- 9123109 Revised 0613 0/17 FAX: FAX: ZIP: ZIP: ZIP: