HomeMy WebLinkAboutREVISION BUILDING PERMITOFFICE USE ONLY:
DATE FILED: S—R
REVISION FEE: *175
PERMIT #
RECEIPT #
PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE REGULATION DIV JON
2300 VIRGINIA AVENUE
Di
a, 14
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FORT PIERCE, FL 34982-56 6e- " I VMt�l
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(772)462-1553
APPLICATION FOR BUILDING PERMI Is IS
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PROJECT INFORMATION
LOCATION/SITE
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DETAILED DESCRIPTION OF PROJECT —ww uounty
REVISIONS: 2 1p_ w. n V a C3 4-k Le, Z'
I CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #: (� p 60 3 c,
BUSINESS NAME: C) lip, d
QUALIFIERS NAME: V`'
ADDRESS: rbg`bL Sw-
CITY: '64 STATE:
PHONE (DAYTIME): -I-L72I LD`P
OWNER/BUILDER INFORMATION:
NAME: V"/v
ST. LUCIE CO CERT. #:
FAX:
ADDRESS:
CITY: STATE: �
PHONE (DAYTIME: FAX:
ARCHITECT/ENGINEER INFORMATION:
NAME:
ADDRESS:
CITY:
PHONE (DAYTIME):
STATE:
rtIA;
ZIP:
ZIP:
ZIP:
SLCCC: 9123109 9% ^
ri bi Revised 06130117 Flulm LAW