HomeMy WebLinkAboutREVISION - BUILDING PERMITOFFICE USE ONLY:
II
DATE FILED:
REV ION FEE:
i
LOCATION/SITE
ADDRESS:2
PERMIT #
RECEIPT #
PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE REGULATION DMSION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982.5652
(772) 462-1553
APPLICATION FOR BUILDING PERMIT REVISIONS
PROJECT INFORMATION
DETAILED DESCRIPTION OF PROJECT
CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #:
BUSINESS NAME:
QUALIFIERS NAME:
i ADDRESS:
1 CITY: STATE: _
'PHONE (DAYTIME):
1
I
OWNER/BUILDER INFORMATION:
NAME:
!ADDRESS:
!CITY: I ST
PHONE (DAYTIME: 3
1' .
ARCHITECT/ENGINEER INFORMATION:
,I .
NAME:
ADDRESS:
CITY: STATE:
PHONE (DAYTIME):
SLCCC: 9123109
Revised 06130/17
I
I
ST. LUCIE CO CERT. #:
ZIP:
FAX:
I
ZIP:
SC K",
St LUCIe County