HomeMy WebLinkAboutREVISION BUILDING PERMIT,A 4
OFFICE USE ONLY:
DATE Ill.". D:'_I�1
REVISION 141t': � �� o
PERMIT # I M I
RECEIPT # j S9
PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE REGULATION DIVISION
2300 VIRGINIA AVENUE "
FORT PIERCE, FL 34982.5652
(772) 462.1553 -
APPLICATION FOR BUILDING PERMIT REVISIONS t9t4t t®�y
PROJECT INFORMATION��44
LOCATION/SITE
ADDRESS.: � •t
2 2 W 5 4- 2 t9 --7 x , f 7- ! 2
DETAILED DESCRIPTION OF PROJECT
RF ISIQNS:
CONTRACTOR INFORMATION:
STATE of FL REWCERT. #: ST. LUCIE,CO CERT. #:
BUSINESS NAME: CrYlSkI�rA lI �1
QUALIFIERS NAME: V
ADDRESS: 3 W an C _ t rn 7.S
CITY: STATE: ZIP: �L
PHONE (DAYTIME): FAX: 2.. 2D Ltd
OVI NER/BUILDER INFORMATION:
NAME: >C)' l n
ADDRE S:
CI1iY: STATE:. ZIP:
PHNF, (DAYTIME: FAX:
ARCHITECT/ENGINEER INFORMATION: ---.
NAME:
ADDRESS:
Cl*: STATE: ZIP:
PHONE (DAYTIME): FAX:
SLt7�CG' 9/23/09
Rerisecl 0(430/17 % REVISION
I@