HomeMy WebLinkAboutREVISION BUILDING PERMITI� I
OFFICE USE ONLY: Z
DATE FILED: ' Z / / G
REVISION FEE:
PERMIT # / d ! - 0 2. ,
RECEIPT # IV 7 to Z)--V
PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE REGULATION DIVISION SCANNED
2300 VIRGINIA AVENUE BY
FORT PIERCE, FL 34982-5652 St Lucie Count
(772) 462-1553 y
APPLICATION FOR BUILDING PERMIT
PROJECT INFORMATIONllf—VIS LOCATION/SITE I
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ADDRESS: �� �� ` �� C�✓U�
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DETAILED DESCRIPTION OF PROJECT
' REVISIONS:
! CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #:
BUSINESS NAME: r /.A
QUALIFIERS NAME:'
ADDRESS:
CITY: STA
PHONE (DAYTIME): 77- ;? of !j' - 59 j-7
9 9OWNER/BUILDER INFORMATION:
!NAME:
ADDRESS:
!CITY:
PHONE (DAYTIME:
ARCHITECT/ENGINEER INFORMATION:
NAME: D ?'4SS0 z
,ADDRESS:
(CITY: Arl
STATF
PHONE (DAYTIME):
SLCCC: 9123109
!Revised 06130117
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ST. LUCIE CO
ZIP:
ZIP:
FAX:. A c;�
T. #:
JAN 2 3 2019
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Permitting Department
St. Lucie County, FL