HomeMy WebLinkAboutREVISIONS - BUILDING PERMITOFFICE ;USE ONLY: ;cam
DATE FILED:
REVISION FEE:
I. LOCATION/SITE
ADDRESS:
2.
9
5.
PERMIT # 16 / -.
RECEIPT #
R E7 11-7— �, V
PLANNING & DEVELOPMENT SERVICES
OCT ��
BUILDING & CODE REGULATION DIVISION
a o-
2300 VIRGINIA AVENUE
P E R M TTI N G
FORT PIERCE, FL 34982-5652
(772) 462-1553 FAX (772) 462-1578
St. Lucie County, FL
APPLICATION FOR BUILDING PERMIT REVISIONS
PROJECT INFORMATION
SCANNED
hA
By
St Lucie Couni
i DETAILED DESCRIPTION OF PROJECT
CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #:
BUSINESS NAME:
QUALIFIERS N :
ADDRESS: l
CITY: Zz
PHONE (DAYTIME): �
OWNER/BUILDER INFORMATION:
NAME:
ADDRESS:
CITY:
PHONE:
ARCHITECT
NAME:
ADDRESS:
CITY:
PHONE (DAI
Revised 07/22/201
i
-& PIooZSST.L
s � n
STATE:
FAX:
STATE:
FAX:
CERT. #:
ZIP:
ZIP:
OFFICE USE ONLY:
/
DATE FILED: �j �/ � ` r20417
REVISION FEE:
PERMIT #
RECEIPT # t t r
PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE REGULATION DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553 FAX (772) 462-1578
APPLICATION FOR BUILDING PERMIT REVISIONS
PROJECT INFORMATION
1. LOCATION/SITE A2( `I c"""ADDRESS:L
2. DETAILED DESCRIPTION OF PROJECT
REVISIONS: •_10
3.
4.
S.
CONTRACTOR INFORMATION::/ ,. _
STATE of FL REG./CERT. #: & f e d54 �lJ LUCIE CO ERT.
BUSINESS NAME:
QUALIFIERS NAME: .
ADDRESS: one
CITY: STATE: ZIP:
PHONE (DAYTIME): j -FAX:
1•
OWNER/BUILDER INF�O/R)M/A�TION:
NAME:
ADDRESS:
CITY: STATE: ZIP:
PHONE: FAX:
ARCHITECT/E.
NAME:
ADDRESS:
CITY:
PHONE (DAYT]
Revised 07/22/2014
WX j
IJ