HomeMy WebLinkAboutREVISION 1-10-19BY
RME VWISI(JN,.
OFFI USE ONLY: DATE
JIED: \v�'q� 1REVISFEE: .0 a- -
TION/SITE
REGEI��[�
JAN 10','' ?a�
cT+ 6�i Cq;f'tc.1`: t'f`i'„feCinn j
PERMIT #
RECEIPT #
PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE REGULATION DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462.1553
APPLICATION FOR BUILDING PERMIT REVISIONS
PROJECT INFORMATION
I
AILED'DESCRII'TION OF PROJECT
)NTRACTOR INFORMATION:
ATE of FL REG./CERT. #: 0 ()0 1 MI5 $ Y t Vo� ST. LUCIE CO CERT. #:
JSINESS NAME: ,Sc*� i ►t Per enot S bU Q c7G- "of-
JALIFIERS NAME: t a_d t1 sA6
)DRESS: p i ocb-05
TY• ec STATE: 4= L- ZIP: 3 3 V 6 3
[ONE (DAYTIME): S&l `5 �?6 - D4 /:_ FAX:
NNER/BUILDER INFORMATION:
,Iv1E: �o to \rN (N-,o 2 (n -
)DRESS -
Ty: STATE: ZIP:
[ONE (DAYTEM E: FAX:
tCHITECT/ENGINEER INFORMATION:
DRESS: u
: STATE: ZIP:
ONE (DAYTIME): FAX: