HomeMy WebLinkAboutREVISION - BUILDING PERMITI
OFFICE USE ONLY: //,,
DATE FILED:
4.
REVISION FEE: Z--®
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PERMIT #
RECEIPT # � /
PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE REGULATION DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 3
(772) 462.155 _.
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APPLICATION FOR BUILDING PERMIT REVISIONS
PROJECT INFORMATION SCANNED
LOCATION/SITE �Y
A St BY
County
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DETAILED DESCRIPTION OF PROJECT
REVISIONS: < _ r _.( (1 _ c ( C _
CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #.k-bC
BUSINESS NAME:
QUALIFIERS
ADDRESS: ` • &W
CITY: 2A\,rv\ Cry STA
PHONE AYTIME): �7
OWNER/BUILDER INFORMATION:
I
ST. LUCIF CO CERT.
ZIP:�(�
FAX: f1
NAME:
ADDRESS:
CITY: STATE: ZIP:
PHONE (DAYTIME: FAX:
ARCHITECT/ENGINEER INFORMATION:
� NAME: 1 cL V Y
!ADDRESS: ► c,-) S i -,o aA—
CITY: S�t aCA, STATE: ZIP:.
PHONE (DAYTIME): -L 2 _ FAX:
SLCCC: 9123109
Revised 06130/17
;� 19 2018
ST Lucie
CoU
ntyt Permitting