HomeMy WebLinkAboutREVISION - BUILDING PERMIT - 11-28-18OFFICE USE ONLY: FILE CGt APPROVE
DATE FILED: 0 PERMIT #
REVISION FEE: OQ RECEIPT #
PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE REGULATION DMSION
2300 VIRGINIA AVENUE RECEIVED
FORT PIERCE, FL 34982-5652
(772) 462.1553 N O V 2 8.2018
APPLICATION FOR BUILDING PERMIT REVISI Imo-, Lucie County, Permitting
PROJECT INFORMATION
LOCATION/SITE
ADDRESS: SCANNED
1� 7od Aa-
St Lucie County
DETAILED DESCRIPTION OF PROJECT
aft ev 4F co
CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #: ST. LUCIE CO CERT. #: .
BUSINESS NAME:
QUALIFIERS NAME:
ADDRESS: If(ri';p- / /Ci� O.0 .d•-
CITY: /-( A e.-e• STATE: ZIP: 3,4,5'O47
PHONE (DAYTIME): 77,) - a'eG —!3/ o FAX:
OWNER/BUILDER INFORMATION:
NAME:
ADDRESS: 701i a C
CITY: STATE: ZIP: SYg� 7
PHONE ( AYTIME: FAX:
ARCHITECT/ENGINEER INFORMATION:.
NAME: �JA/
ADDRESS: pw A..- ,
CITY: lrlx- G11- STATE: 1t=L
PHONE (DAYTIME): FAX: _
SLCCC: 9123109
Revised 06130117
REVISION