HomeMy WebLinkAboutREVISION 11-14-18OFFI(� E USE ONLY:
DATE ILED:-
REVI ION FEE
REcEIVFD
Nov 141018
Permitting ;,,
St [ucie counL'at' e7
LOCATION/SITE
ADDRESS: 1rf
BY
LodeGaLl'atv U PERMIT # � v V_D L16
RECEIPT #
PLANNING & DEVtLOPMENT SER,
BUILDING & CODE REGULATION DIV,ifl
2300 VIRGINIA AVENUE I Kf i w; 1
FORT PIERCE, FL 34982.56 :r t
(772) 462.1553
APPLICATION FOR BUILDING PEIT RE INS
PROJECT INFORMATI COPY
�U�5�n��-I�u► � C�V�1-� �(v►n Cil�1 �L ��a��
DETAILED DESCRIPTION OF PROJECT
CONTRACTOR INFORMATION:
STATE of FL REG./CERT #:
BUSINQuIES NAME:;
G G
NSM) :
lsl
ADDREF :
CITY: Oku l
PHONE AYTI
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OWNER/BUILDER INFORMATION:
NAME:
ADDRESS:
ST. LUCIE CO CERT. #:
19"'%
CITY: STATE: ZIP:
PHONE (DAYTIME: FAX:
ARCHITECT/ENGINEER INFORMATION:
NAME:
ADDRESS:
CITY: STATE:
PHONE (DAYTIME):
I
SLCCC. 9123109
Revised 06130/17
ZIP:
ST. LUCIE COUNTY BUILDING DIVISION
REVIEWED FOFR
REVIEWED BY ''''ff���"'OI�IIPLIANCE
DATE - ry -j
PLANS AND PERMIT MUST BE KEPT ON JOB
OR NO INSPECTION WILL BE MADE,