HomeMy WebLinkAboutREVISIONS - BUILDING PERMIT APPLICATIONOFFICE USE ONLY: n �/
DATE FILED:
REVISION FEE:
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ADDRESS:
PERMIT # - 31
RECEIPT #
PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE REGULATION DIVISION
2300 VIRGINIA AVENUE RECEIVED
FORT PIERCE, FL 34982.5662
(772) 462.1553 FEB 0 7 2019
APPLICATION FOR BUILDING PERMIT REVISIONS ST. Lucle County, Permitting
PROJECT INFORMATION
Lucie County
DETAILED DESCRIPTION OF PROJECT
CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #:
BUSINESS NAME:
QUALIFIERS NAME:
ADDRESS:
CITY:
PHONE (DAYTIME):
STATE:
OWNER/BUILDER INFORMATION:
NAME:
CITY: -�C
PHONE (DA
ARCHITECT/ENGINEER INFORMATION:
NAME: _
ADDRESS:
CITY:
PHONE (DAYTIME):
STATE:
ST. LUCIE CO CERT. #:
_ ZIP:
FAX:
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ZIP:
FAX:
ZIP:
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OFFICE USE ONLY: y
DATE FILED: L �T I ct
REVISION FEE:
PERMIT # I� I 1-0 5 31
RECEIPT #
PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE REGULATION DIVISION
2300 VIRGINIA AVENUE RECEIVED
FORT PIERCE, FL 34982.5652
(772) 462.1553 FEB 0 7 Z019
APPLICATION FOR BUILDING PERMIT REVISIONS Si, Lucle County, Permitting
PROJECT INFORMATION
LOCATION/SITE
ADDRESS: SCANNj'®
DETAILED DESCRIPTION OF PROJECT
CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #:
BUSINESS NAME:
QUALIFIERS NAME:
ADDRESS:
CITY:
PHONE (DAYTIME):
STATE:
OWNER/BUMDER INFORMATION:
NAME:
CITY:
PHONE(DA
ARCHITECT/ENGINEER INFORMATION:
NAME:
ADDRESS:
CITY:
PHONE (DAYTIME):
STATE:
ST. LUCIE CO CERT. #:
FAX:
rax:
ZIP:
ZIP:
SLCCC: 9123109
Revised 06/30/17 ® EV I S I
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