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HomeMy WebLinkAboutREVISION - BUILDING PERMITOFFICE USE ONLY: f /,, DATE FILED: 1 PERMIT # l0- l ©�l REVISION FEE: RECEIPT I PLANNING & DEVELOPMENT Srim S COPY BUILDING & CODE REGULATION D 2300 VIRGINIA AVENUE FORT PIERCE, FL 34982.5652 j (772) 462-1553 APPLICATION FOR BUILDING PERMb UN RVSVj'0"�kj PROJECT INFORMATION LOCATION/SITE SCANNED ADDRESS: BY SULude County DETAILED DESCRIPTION OF PROJECT nTll7rcrr►T.rc. CONTRACTOR INFORMATION: I STATE of FL BUSINESS NAMEREG./CERT. ,(G S ` �,T L�UC�I^NCO CERT. :^ [ QUALIFIERS NAME: �t ADDRESS: CITY: C-STATE: , ZIP: PHONE ( AYTIME): 77 _ — S FAX: - OWNER/BUILDER INFORMATION: NAME: ADDRESS: CITY: PHONE (DAYTIME: ARCHITECT/ENGINEER INFORMATION: NAME: TE: FAX: SLCCC: 9123109 Revised 06130117 JAN 2 3 2019 ZIP: ZIP: 5 ;26) 1 ED I ( - ` '�rlls U Permitting Department St. Lucie County, FL