HomeMy WebLinkAboutREVISION OF PERMIT REVISION - 12-28-18i
OFFICE
DATE
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FEE: �.
PERMIT # Ito
RECEIPT #
PLANNING & DEVELOPMENT SERVICES
BUILDING'& CODE REGULATION DMSION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982.5652
(772) 462.1553
APPLICATION FOR BUILDING PER
PROJECT INFORMATION
ILL LOCATION/SITE COPY
ADDRESS: SCANNED
BY
St Lucie County
DETAILED DESCRIPTION OF PROJECT
REVISIONS: ff
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11 CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #: ST. LUCIE CO CERT. #: D
BUSINESS NAME: t QoLT
QUALIFIERS NAME:
ADDRESS: 3a 1
CITY: lFop+ STATE: �-
PHONE (DAYTIME): (7 7,1 4(0S - a ? (DoFAX:
OWNER/BUILDER INFORMATION:
NAME:
ADDRESS:
CITY:
PHONE (DAYTIME:
ZIP:
STATE: ZIP:
FAX:
ARCHITECT/ENGINEER INFORMATION:
NAME:
ADDRESS:
CITY:
PHONE (DAYTIME):
SLCCC: 9123109
Revised 06130/17
STATE:
ZIP:
417
DEC 2 8 2018
Permitting Department
St. Lucie County, FL