HomeMy WebLinkAboutREVISION - BUILDING PERMITOFFICE USE ONLY: 4
DATE FILED:
REVISION FEE:
LOCATION/SITE
ADDRESS: I ,1
PERMIT # `"1 n 2 - (V
SA
RECEIPT # t S 15 'a
PLANNING & DEVELOPMENT SERVICES RECEIVED
BUILDING & CODE REGULATION DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652 AUG 2 9 ?0?9
(772)462.1553
ST. Lucie County, Permitting
APPLICATION FOR BUILDING PERMIT REVISIONS
PROJECT INFORMATION
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DETAILED DESCRIPTION OF PROJECT
CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #:
BUSINESS NAME:
QUALIFIERS NAMES
ADDRESS: 1-k ej PL
CITY: STATE:
PHONE (DAYTIME): �2�[,aPg Co Z
OWNER/BUILDER INFORMATION:
NAME: M/i V %0M
CITY: b � Y, ; e P c0— STATE:
PHONE (DAYTIME: %72-A1$-6640
ARCHITECT/ENGINEER INFORMATION:
NAME:
ADDRESS:
CITY:
PHONE (DAYTIME):
STATE:
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ST. UCIE CO CERT. #:
ZIP:
FAX:
FAX:
09
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ZIP:
ZIP:
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OFFICE USE ONLY:
DATE FILED: /' 1
REVISION FEE: Jg- 0 0
PERMIT # M o Z - I -1
RECEIPT #
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PLANNING
ERVICES
BUILDING& ODE VRG ATIOED�NUE ON Cl
LE COPY
FORT PIERCE, FL 34982
(772)482-1553 pffsomm,
APPLICATION FOR BUILDING PERMIT REVISIONS
PROJECT INFORMATION
LOCATION/SITE
DETAILED DESCRIPTION OF PROJECT
CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #:
BUSINESS NAME: e61 k
QUALIFIERS NAME:
CITY: )- ont - Vl gyice `J STA
PHONE (DAYTnNE):
OWNER/BUILDER INFORMATION:
SAME:
CITY: �:vFk T" eYc-e
PHONE (DAYTIME: -7 7 2 -
ARCHITECT/ENGINEER INFORMATION:
NAME:
CITY: i-oti
PHONE (DA
SLCCC.• 9123109
Revised 06130117
LUCIE CO CERT. #: �':>'0N(�
FAX:
FAX:
STATE: F'L
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JUN 7 2019
Permitting Department
St. Lucie County, FL