HomeMy WebLinkAboutREVISION - BUILDING PERMITr
OFFICE USE ONLY:
DATE ED: /�• ) Ly ' I
REVISION FEE: 9�s—• 0 D
PERMIT #
RECEIPT #
PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE REGULATION DIVISION GOVN GO �Q't oNMPO0'
2300 VIRGINIA AVENUE �,vp �y
FORT PIERCE, FL 34982.565P! ' \1000,0
ON�51
(772)462.1553
APPLICATION FOR BUILDING PERMIT 0� ION
PROJECT INFORMATION
LOCATION/SITE
ADDRESS: 5703 D LCft bet 13LuQ
Pr -DI Utz O;nA
DETAILED DESCRIPTION OF PROJECT k`��'i�
REVISIONS: cola
CAN �, I ►� c� Lrnh��-5 l�� �N�I D(� U� l)6e
CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #:
BUSINESS NAME: t
QUALIFIERS NAME: _ kT
ADDRESS: 5
CITY: C4
PHONE (DAYTIME):
C CIC 157-21Sq
STATE:
elf- LI 4
OWNER/BUILDER INFORMATION:
NAME:
ADDRESS:
CITY:
PHONE (DAYTIME:
STATE:
ARCS ITECT/ENGINEER INFORMATION:
ST. LUCIE CO CERT. #:
9M
I ,VA
ZIP:
ZIP:
NAME:
ADDRESS:
CITY: STATE: ZIP:
PHONE (DAYTIME): FAX:
SLCCC. 9123109
Revised 06130117
RECEIVED
NOV 16 2018
Permitting Department
St. Lucie County, FL