HomeMy WebLinkAboutAPPLICATION FOR PERMIT REVISIONSM USE ONLY: ,(CANNED
B�n 4 ERMIT #- )
FILFn! _ > > i "1 ' 5t, ,LUOO e oU
ION FEE: -V .ARECEIPT #
j PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE REGULATION DIVISION
2300 VIRGINIA AVENUE RF�F!`FQ
RECEIVED FORT PIERCE, FL 34982.5652 *01/
1
(772j 462.1553 Perms. 9
NOV 0 5 2018 2�
Sr art„'9 0 1®
Permitting department APPLICATION FOR BUILDING PERMIT REVISIONS 4�% eo Prnehr
St, Lucie County PROJECT INFORMATION
LOCATION/SITE
ADDRESS:
►N,)LO bps r
a 9
DETAILED DESCRIPTION OF PROJECT
REVISIONS:
m AC
18 , mb PS-X-0 (gyp
CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #: LAK
BUSINESS NAME: (3rnac A C_
QUALIFIERS NAME: r0S
ADDRESS: jLot 'C:c sefe=
CITY: —P C, c, ;
PHONE (I�)AYTIIVIEI
NAME: PEU I T Y-MSeAr-
ADDRESS: t-SDt.e p1Lil
CITY: Vrr% ST
PHONE (DAYTDAE: `Z I �i Si 7 C Q L
ARCIHTECT/ENGINEER INFORMATION:
NAME:
ADDRESS:
CITY: STATE:
PHONE (DAYTIME):
ST. LUCIE CO CERT. #:
FAX: 73P -,
AX:
ZIP:
--
Revised 0613 0/17
FlLh
VOPY