HomeMy WebLinkAboutREVISION - BUILDING PERMITa
OFFICE USE ONLY:
DATE FILED: - ' I
REVISION FEE:00
PERMIT # 1 1y— O G b
RECEIPT #
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BUILDING & CODE REGULATION DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
APPLICATION FOR BUILDING PERMIT REVISI
PROJECT INFORMATION
L®CATION/SITE
ADDRESS: � SI n
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RECEIVED
AUG 0 6 2019
ST. Lucie County, Permitting
SCANNED
BY
C St Lucie County
DETAILED DESCRIPTION OF PROJECT
REVISIONS:
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CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #:
BUSINESS NAME: I
QUALIFIERS NAME: �:-1
ADDRESS: iullkaC
CITY: - r`r STATE:
PHONE (DAYTIME): S'S y ij/ p -22
dWNER/BUILDER INFORMATION:
NAME: �\ o U Zcln 0
ADDRESS: 1
CITY: a Y Ce STATE:
PHONE (DAYTIME: q-.S V V) O
ARCHITECT/ENGINEER INFORMATION:
I
NAME:
ADDRESS:
CITY: STATE:
PHONE (DAYTIME):
V'ro clvA
ST. LUCIE CO CERT. #:
ZIP:
FAX:
\bm Cl fk ZIP:
FAX:
FAX:
ZIP:
4CCC: 9123109
Revised 06130117
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