HomeMy WebLinkAboutREVISION 1- OFFICE USE ONLY:
aLANNED
St. Luce County
DATE FILED: I • I - 19
REVISIONFEE: 75 of
PERMIT # / 1 V 7 � OS L ?—
RECEIPT # Dona 12 t45'.i 1
PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE REGULATION DIVISION
FORT
PIERCE,
F AVENUE
I FORT PIERCE, FL 34982.5652
(772)462.1553
vwpy APPLICATION FOR BUILDING PERMIT REVISIONS JAN 10 2018
PROJECT INFORMATION
LOCATION/SITEhim
=9 I L Em ug" PIA7
ADDRESS: �
3204 s 4.4kc N'ew AAO
Faar Pi6t.CC. it 3VFV9
DETAILED DESCRIPTION OF PROJECT
D V vrcrnwQ.
CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #:
BUSINESS NAME: ✓mlec.
QUALIFIERS NAME: C JW
ADDRESS: I la 0 4 1
CITY: 1/1-Ay STATE: F/
PHONE (DAYTIME): 9T7- 707 - 0674
OWNER/BUILDER INFORMATION:
NAME:
ST. LUCIE CO CERT. #:
xP)g-
_ ZIP: 3 2 9G c
FAX:
CITY: /•'stir 4 exec STATE: P-/
PHONE (DAYTIME: FAX: _
ARCHITECT/ENGINEER INFORMATION:
NAME: M(jl% 9✓�d.itex.'�t—
ADDRESS: ,1,9 3 {' o Tti .4 r
CITY: UGna &4act% STATE: 6:1
PHONE (DAYTIME): 77Z - SGi - aO 3S FAX: _
SLCCC: 9123109
Revised 06130117
ZIP:
ZIP: 3 29 G 0
lz I