HomeMy WebLinkAboutREVISION BUILDING PERMITf
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OFFICiE USE ONLY:
DATE FILED:
REVISION FEE: 1 5 • d a
LOCATION/SITE
ADDRESS:
PERMIT #
RECEIPT #
PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE REGULATION DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982.5652
(772) 462.1593
APPLICATION FOR BUILDING PERMIT REVISIONS
PROJECT INFORMATION
DETAILED DESCRIPTION OF PROJECT
RF.ViCTnNC.
CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #:
BUSINESS NAME:
QUALIFIERS NAME:
ADDRESS:
CITY:
PHONE (DAYTIME):
STATE:
OWNER/BUILDER INFORMATION:
St, u ( o L
Date I . it
pr ve
ST. LUCIE CO CERT. #:
FAX:
ZIP:
NAME:
ADDRESS: ::3 a a 3 ee r o c k. a%I-*.
CITY: " • V% -- yet STATE: T-1^ ZIP: 16L ' C\%
PHONE (DAYT%lE: 'L,,q G FAX:
ARCHITECT/ENGINEER INFORMATION:
NAME:
ADDRESS:
CITY:
PHONE (DAYTIME):
STATE: ZIP:
FAX:
SCANNED
BY
St Lucie County
SLCCC: 9123109
Revised 06130/17
014 Copy
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