HomeMy WebLinkAboutREVISION - BUILDING PERMIT_ . S_
DATE
OFFICE USE ONLY:
FEE:
F�
1
S'F C4 eOepd r PP i� ��
cO�PT # L d`` G'
RECEIPT #
i
PLANNING & DEVELOPMENT SERVICES;
BUILDING & CODE REGULATION DIVISION I
2300 VIRGINIA A E f ..
FORT PIERCE, FL
(772) 46215
APPLICATION FOR BUILDING 1?ER4T 1#liQ s,r�
PROJECT INFORMATf
PRO
LOCATION/SITE
ADDRESS:
570Z Rki! 6U. — t1D'O&
SCANNED
DETAILED DESCRIPTION OF PROJECT BY
REVISIONS: sue_• Wele C�Ounty
(CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #: W I a 3/1/5/ ST. LUCIE CO CERT. #:
'BUSINESS NAME: r8amCa
QUALIFIERS NAME: G - F4jwcr,J
ADDRESS: 4(0 Z s'. ll ( w
',CITY: - '. - STATE: �� ZIP:
PHONE (DAYTIME): 7 qU -37 Y -3 0 U i FAX:
� OWNER/BUILDER INFORMATION:
NAME: 1&,fp_lVn me&dows
'ADDRESS: to e cs Tifr
i CITY: STATE: .
PHONE (DAYTWE: 77 a yR - 7 U� FAX:
ARCFaTECT/ENGINEER INFORMATION:
NAME:
ADDRESS:
CITY:
PHONE (DAYTR%4E):
SLCCC: 9123109
Revised 06130117
STATE:
FAX:
III'