HomeMy WebLinkAboutREVISION 5-28-19"A i �r '10%ldoty'
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RE,', ISION FEE: ' �a
PERMIT # i e,6 3 aG o
RECEIPT # z
PLANNING & DEVELOPMENT SERVICESERECEUE�
BUILDING & CODE REGULATION DIVISION2300 VIRGINIA AVENUEFORT PIERCE, FL 34982-5652 ?0i9(772) 462-1553 y, F F9fttt;r,q
APPLICATION FOR BUILDING PERMIT REVISIONS
PROJECT INFORMATION
LOCATION/SITE
ADDRESS:
6UAN Y QED
DETAILED DESCRIPTION OF PR CT BYREVISIONS:fit, LUCI(a CQ�B
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CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #: Ut'C
BUSINESS NAME: r-01 C:'l
QUALIFIERS NAME: ; �P2 SP2, ry
ADDRESS: S /1i
CITY: 1%itsi STA
PHONE (DAYTIME): W-cl
NAME:
ADDRESS:
CITY:
INFORMATION:
31S/ C6-�
PHONE (DAYTIME:
3 (/ ST. LUCIE CO CERT. #:
ZIP: 3 21C-,:z
at Z."r- FAX: -
ARCHITECT/ENGINEER INFORMATION:
NAME:
ADDRESS:
CITY: Q,�r� z
PHONE (DAYTIME):
SLCCC: 9123109
Revised 06130/17