HomeMy WebLinkAboutAPPLICATION FOR BUILDING PERMITOFFICE USE ONLY: S�Amluw
DATE FILED: �' �' i3 p gg PERMIT #
REVISION FEE: /'�-• kc �L�Q'V��u RECEIPT #
PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE REGULATION DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982.5652
(772) 462.1553
APPLICATION FOR BUILDING PERMITSOMARIMAL
PROJECT INFORMATION
LOCATION/SITE
ADDRESS:.
DETAILED DESCRIPTION OF PROJECT
levy ho
CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #: q / 6 zff ST. LUCIE CO CERT. #:
BUSINESS NAME:
QUALIFIERS NAME: / �k
ADDRESS:
CITY: STATE:
PHONE (DAYTIME): 7_ f - �'S'� FAX:
OWNER/BUILDER INFORMATION:
NAME:
ADDRESS:
CITY:
PHONE (DAYTIME:
STATE:
ARCHITECT/ENGINEER INFORMATION:
NAME:
ADDRESS:
CITY:
PHONE (DAYTIME):
SLCCC: 9123109
Revised 07117118
STATE:
I
FAX:
ZIP:
ZIP:
DEC 13 2018
Permitting Department
St. Lucie County, FL