HomeMy WebLinkAboutREVISIONOFFICE USE ONLY:
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REVISION FEE: 7ri3OO
1. LOCATION/SITE
ADDRESS:
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MAR 2 3 2017
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BY
St. Lucie County
PERMITTING PERMIT# Lr% 0 2
St. Lucie County, FL RE
CEH'T #
PLANNING & DEVELOPMENN�C
BUILDING &CODE REGULATI N D IO
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2300 VIRGIMAAVE
FORT PIERCE, FL 34982-5652
(772) 462-1553 FAX (772) 462-1578
APPLICATION FOR BUILDING PERMIT REVISIONS
PROJECT INFORMATION
2. DETAILED DESCRIPTION OF PROJECT
REVISIONS:
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3.
4.
5.
CONTRACTOR
STATE of FL REG./CERT. #: CGC
BUSINESS NAME:
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QUALIFIERS NAME:
0*
ADDRESS:
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CITY:
8 e
PHONE (DAYTIME):
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OWNER/BUILDER INFORMATION:
NAME:
ADDRESS:
LUCIE COUNTY CERT. #: a0?od o
STATE:
FAX:
ZIP:
CITY: STATE: ZIP:
PHONE: FAX:
ARCHITECT/ENGINEER INFORMATION:
NAME:
ADDRESS:
CITY: STATE: ZIP:
PHONE (DAYTIME): FAX:
Revised 07/22/2014
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