HomeMy WebLinkAboutREVISION - BUILDING PERMITOFFICE USE ONLY:
DATE FILED: I y I
REVISION FEE:
PERMIT # [8 to — 3s
RECEIPT #
PLANNING & DEVELOPMENT SERVICES Z. u T
BUILDING & CODE REGULATION DIVISION S1e O.
2300 VIRGINIA AVENUE Date, N� l it
FORT PIERCE, FL 34982.5112 pr e
F-c:
(772) 462.1553r-tr L, �G'�NN�D
`n" APPLICATION FOR BUILDING PERMIT, 10 S St LuC'ay
PROJECT INFORMATION c®Ury�
ILOCATION/SITE
"DRESS: / t / i
rO47- 19-1 �2-6
DETAILED DESCRIPTION OF PROJECT
REVISIONS: �
60' � `70 LJr -(a 60 'K
AIVATC -ro SZ�4
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CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #:
BUSINESS NAME:
QUALIFIERS
ADDRESS:
CITY:
PHONE (DAYTIME):
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STATE:
UWNER/BUILDER INFORMATION:
NAME: /)A:1;�e CIA- has
ADDRESS: &106 S1t-u4e c)Ak 69.
CITY: ! �,/1 ►���,2 C� STATE:
PHONE (DAYTIME:
ARCHITECT/ENGINEER INFORMATION:
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NAME:
ADDRESS:
CITY: STATE:
PHONE (DAYTIME):
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S�LCCC: 9123109
Revised 06130117
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ST. LUCIE CO CERT. #:
FXW
FAX:
FAX:
ZIP:
ZIP:
ZIP: