HomeMy WebLinkAboutAPPLICATION FOR PERMIT REVISIONSOFFICE USE ONLY: SCANNED
DATE FILED: Zo BY
V R V i.k 10 N�; E St. Lucie County
-
PERMIT
RECEIPT #
PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE REGULATION DIVISION
.2300 VIRGINIA AVENUE
rg�� if FORT PIERCE, I - L 11111,1111
(772) 4621-1#53
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APPLICATION FOR BUILDING PERMIT REVISIONS
PROJECT INFORMATION
LOCATION/SITE
ADDRESS:
DE TAILED DESCRIPTION OF PROJECT
REVISIONS:
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CONTRACTOR INFORMATION:
STATE of FL REG./CERT. -.ST..IUCIE CO CERT. #:
BUSINESS NAME: -S>Ai-44rb9,rays "Ma) CQeP,
QUALIFIERS NAME: 'jZpeF-e Sr�trnA-
ADDRESS:
CITY: CCVPevxATee STATE: AEL ZIP:. 32-7h5-
PHONE (DAYTIME):. " ,�-7
FAX: 89
OWNEWBUILDER INFORMATION:
NAME: ctU
ADDRESS: 117,41,000d &LQJ WA!l
CITY: STATE, .4L
PmoNE (DAYTIME: FAX:
ARCHITECT/ENGINEER INFORMATION:
NAME:
CITY: 3AwAoosujg-� STATE: Ft,.
PHONE(DAYTIME): FAX:
SLCCC: 9123109
Revised 0613 0/17
ZIP: S(030
ZIP: