HomeMy WebLinkAboutREVISION BUILDING PERMIT - 11-14-18OFFICE USE ONLY:
DATE FILED:I9'
REVISION FEE:
I
PERMIT # 0 10 -- d & 7 l
RECEIPT #
PLANNING & DEVELOPMENT
BUILDING & CODE REGULATIOP
2300 VIRGINIA AVE
FORT PIERCE, FL 349
(772) 462-1653
APPLICATION FOR BUILDING PI
PROJECT INFORMATION
LOCATION/SITE
ADDRESS:
11.E i D
$C� NED
DETAILED DESCRIPTION OF PROJECT
REVISIONS:
1 • F)?,a eAPA Q 7 7! /l�bYr,- D i o RD�o /1 61E5V
CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #: G Pe, I L)5'7
BUSINESS NAME: G 2V 57-Aj- PyOZ65
QUALIFIERS NAME: /71) Z L
ADDRESS: L% b s? y U 6, f
_ ST. LUCIE CO CERT. #:
/2) V OYL
CITY: U FSTATE: ZIP:
PHONE (DAYTIME): "77 2 9 73 - 2 3 a FAX:
I
OWNER/BUILDER INFORMATION:
NAME: C•� WAD D L,`7 i4 2-l4xl l0F
ADDRESS:
CITY: STATE: ZIP:
PHONE (DAYTIME: FAX:
ARCHITECT/ENGINEER INFORMATION:
NAME: I* C>
ADDRESS:CITY: PALM PALM bcl 6AAQ i�5 STATE: ZIP: 3 3 9/9
PHONE (DAYTIME): 3(oJ 8S3zf FAX:
SLCCC: 9123109
Revised 06130117