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DATE FILED: .�+
REVISION FEE: I'S • O O
PERMIT#,qJ
RECEIPT #
PLANNING & DEVELOPMENT SERVICES
BUILDING & CO2DE 3 0 VDIVISION
VIRGINIA AVENUE aaa OPY
FORT PIERCE, FL 34982.5652 �-
(772) 4553 RINISION
APPLICATION FOR BUILDINDIN G PERMIT
PROJECT INFORMATION
SCANNED
LOCATION/SITE BY
ADDRESS:. I St. Lucie County
-3b0o I�RC)CKS h, / 3
DETAILED DESCRIPTION OF PROJECT
REVISION �c-C Lo, b
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CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #:
BUSINESS NAME: L {�
QUALIFIERS NAME: �v,-
CITY: L),ePn j2pac_ln ST
PHONE (DAYTIME): 7 7,� - c�Q I _
OWNER/BUILDER INFORMATION:
NAME:
ADDRESS:
CITY:-9—
PHONE (D,
ARCIHTECT/ENGINEER INFORMATION:
" NAME: c 'e- ) C w 5
ADDRESS: G a )o G C -e
CITY: r p STATE:
Y PHONE (DAYTIME): -77a - 74, — Ic 6 S—
SLCCC: 9123109
Revised 06130/17
ST. LUCIE CO CERT. #:
ZIP:
FAX:
jZcVIS/ ON
/— ZIP: -3 VC/ 69.
AX:
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FEB 18 2020
Permitting Department
St. Lucie County, FL