HomeMy WebLinkAboutREVISION 12-9-15i
OFFICE USE ONLY: ' )
DATE FILED: �.'�' Jc PERMIT # 1508-0425
REVISION FEE: r]�1� RECEIPT #
PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE REGULATION DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553 FAX (772) 462-1578
APPLICATION FOR BUILDING PERMIT REVISIONS
PROJECT INFORMATION
1. LOCATION/S14r& N H A!A
ADDRESS: Hwy
2. DETAILED DESCRIPTION OF PROJECT
REVISIONS:
Change of elevation, Trusses and Structural areas
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3. CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #: CGC 058625PflurST. LUCIE COUNTY CERT. #:
BUSINESS NAME: mes
A�DDREIFSISERS NA eir—
O N Jog Roadan Suite
toTar120
CITY: es a m beach STATE: ZIP:
PHONE (DAYTIME): - 799-5900 Ext105 FAX:
4. OWNER/BUILDER INFORMATION:
5.
NAME:
ADDRESS:
CITY:
PHONE:
ARCHITECT/ENGINEER INFORMATION:
NAME: Stofft
ADDRESS:
CITY:
PHONE (DAYTIME):
Revised 07/22/2014
STATE:
STATE:
Ong
FAX:
FAX:
ZIP:
ZIP: