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REVISION 7-9-18
SCANNED OFFICE USE ONLY: BY DATE FILED: �. St. Lucie COUht� PERMIT # REVISION FEE: RECEIPT # PLANNING & DEVELOPMENT SERVICES BUILDING & CODE REGULATION DIVISION 2300 VIRGINIA AVENUE FORT PIERCE; FL 34982.5652 (772) 462-1553 IL I APPLICATION FOR BUILDING PER, PROJECT INFORMATION V1 Sl u rq LOCATION/SITE ADDRESS: DETAILED DESCRIPTION OF PROJECT 3 ® REVISIONS: f V 6.9/kip 2-6 °� / s�- /3"-iZ-7 ;�z -/70 rz •- /L7 CONTRACTOR INFORMATION: STATE of FL REG./CERT. #: /,7 L E3 73 7 ST. LUCIE CO CERT. #: BUSINESS NAME: iypv7�� �1�ir� 7 �v5 Lz t- QUALIFIERS NAME: ADDRESS: /!ice �i :��ar�j Z •,/ CITY: P4216�-c e,1,97 STATE: ,P-L ZIP: 3 -7 6� ^� PHON (DAYTIME): FAX: OWNERBUILDER INFORMATION: NAME: ADDRESS: CITY: PHONE (DAYTIME: STATE: ARCHITECT/ENGINEER INFORMATION: NAME: ADDRESS: CITY: PHONE (DAYTIME): SLCCC: 9123109 Revised 06130/17 ZIP: FAX: STATE: ZIP: FAX: JUL 9 2018 Permitting Department St. Lucie County, FL