HomeMy WebLinkAboutREVISION - BUILDING PERMITOFFICE USE ONLY:
DATE FILED:�'!'�
REVISION FEE:
PERMIT# SdG )'!0-'S-02 ,0
RECEIPT #
PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE REGULATION DIVISION
2300 VIRGINIA AVENUE SCANNED
FORT PIERCE, FL 34982.5652 BY
(772) 462.1553 St. Lucie County
APPLICATION FOR BUILDING PERMIT REVISIONS
PROJECT INFORMATION
LOCATION/SITE
ADDRESS:
12 Z S0 ✓ 5Ticc� % � /L--( T% xc e �L .
DETAILED DESCRIPTION OF PROJECT
CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #: <15 G - la
BUSINESSNAME: -''JdLz
QUALIFIERS NAME: 3a 2 . S .A
ADDRESS: /47 C �re�
CITY: ;* c�G� STATE:
PHONE (DAYTIME): 77_02 - 5 77 - c I (- I
OWNER/BUILDER INFORMATION:
NAME:
CITY:
PHONE (DAYTIME:
STATE:
ARCIIITECT/ENGINEER INFORMATION:
NAME: -a e 5
ADDRESS:
CITY: o• i
PHONE (DAYTIME):
SLCCC. 9123109
Revised 06130117
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STATE:
ST. LUCIE CO CERT. #:
FAX:
FAX:
ZIP: