HomeMy WebLinkAboutREVISION 4-18-19L
SCANNED
OFF IC USE ONLY: By
DATE �county
,ILED: St. Lucie
REVIS ON FEE:
I
LOCATION/SITE
ADDRESS:
PERMIT # J (k1 it l 1 l O J.
RECEIPT #
PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE REGULATION DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 3082-5B$2
(772) 462-153 r
APPLICATION FOR BUILDING PERMIT REVISIONS
I F�
PROJECT INFORMATION
DateU Uc 0 Fl/ /^
DETAILED DESCRIPTION OF PROJECT
REVISIONS:
rx L.a c G CL d C-D
CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #:
BUSINESS NAME:
QUALIFIERS NAME:
ADDRESS:
CITY: STATE:
PHONE (DAYTIME):
OWNER/BUILDER INFORMATION:
t
NAME: -C.✓LCA
ADDRESS: 7 ? d 61 Trl-;4
ST. LUCIE CO CERT. #:
FAX:
CITY: F o C STATE: E! a
PHONE (DAYTI FAX:
ARCHITECT/ENGINEER INFORMATION:
NAME:
ADDRESS:
CITY:
PHONE (DAYTIME):
SLCCC: 9123109
Revised 06130117
ZIP:
ZIP:
STATE: ZIP:
FAX:
' -'--'' III -~--
. � . .
-- -----�-�--7~��'�-`- --�- � - --' � 7 -- '- -�-�-'---�---- ---`-
. .
! . ----/ '---- -- -
.
�
° | Ap
^-
.