HomeMy WebLinkAboutREVISION - BUILDING PERMIT 3-8-19I
OFFICE USE ONLY:
DATE FILED: 31�1 V\
REVISION FEE:
PERMIT#
RECEIPT #
KANNED
PLANNING & DEVELOPMENT SERVICES BY
BUILDING & CODE REGULATION DIVISION St Lucile County
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982.5652
(772) 462-1553
APPLICATION FOR BUILDING PERMIT REVIS 0
PROJECT INFORMATION �_
LOCATION/SITE
ADDRESS:
s�eI��� .
j DETAILED DESCRIPTION OF PROJECT
REVISIONS:
I CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #:
BUSINESS NAME:
QUALIFIERS NAME:
ADDRESS:
CITY:
PHONE (DAYTIME):
STATE:
i OWNER/BUILDER INFORMATION:
NAME:
ADDRESS:
CITY: A&e STATE:
PHONE (DAYTIME:
I •
ARCHITECT/ENGINEER INFORMATION:
NAME:
ADDRESS:
CITY:
PHONE (DAYTIME):
SLCCC: 9123109
Revised 06/30/17
i
STATE:
ST. LUCIE CO CERT. #:
ZIP:
FAX:
5220-1� ZIP: :�E�98 Z
FAX:
Z 3'Y05- zzSd
FAX:
ZIP: