HomeMy WebLinkAboutREVISION 1-22-19OFICE USE ONLY: SCANNED
DATE FILED: I as 1`� p BY
PERMiT # SG.� 1 8 O $ — O/6 ? Q
"--k 14011, �,i�4 }I� I RECEIPT # �DV�
REVISION FEE: -
PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE REGULATION DI II �^t�
2300 VIRGINIA AVENUE,, I+7
FORT PIERCE, FL 34982-52
(772) 462-1553
APPLICATION FOR BUILDING PET , 0 `QS[;a
PROJECT INFORMATION _
LOCATION/SITE
ADDRESS:
1$601 trar►Avrl �`l-�i Rose L& Parl- So.,nt `, ,c.-e
DETAILED DESCRIPTION OF PROJECT
REVISIONS:
Rev%se e /&c�'-"-ca./ r'-ser
CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #: G G C O l 3 O 8 9' ST. LUCIE 'CO CERT. #: C Q S X I-S
BUSINESS NAME: P K Ooav,S Consfr„c 4,-en Co,-,O.
QUALIFIERS NAME: /
ADDRESS: PO box J C
CITY: E; r f R c- rce STATE: Fyor; fin` ZIP: 3 Y 1541
PHONE (DAYTIME): ??c),- 4 C / - $ 3 3 S FAX:
OWNER/BUILDER INFORMATION:
NAME: Ser ; o Fernp.n deL
ADDRESS: COW St,- 8 *11 CT
CITY: Pl o• n fo j eo n STATE: Flo r.'d oN
PHONE (DAYTIME: q Sy - 5 81- 31 Q 7 FAX: _
ARCHITECT/ENGINEER INFORMATION:
NAME: P,,, / We / c- /1
ADDRESS: l `t 8y & t4enore ST is / 14
CITY: porf Sn "4-t ['Vc"e- STATE:
PHONE (DAYTIME): Zia - 88e
File Co
SLCCC: 9123109
Revised 06130117
ZIP: -333 / 7