HomeMy WebLinkAboutREVISION 1*jUANNED
BY
OFFICE USE ONLY- 1 t LuciP. Count%
DATE FILED: l� I
REVISION FEE: O
PERMIT # 6 S — C)
RECEIPT #
RECE ED
PLANNING & DEVELOPMENT SERVICES
lco BUILDING & CODE REGULATION DIVISION
Qy S 2ni7
2308 VRiGIMA AVENUE
FORTPIERCE,FL34982-5M PERMITTING
(772) 462-1553 FAX(772) 462-1578 St. Lucia County, FL
APPLICATION FOR BUILDING PERMIT REVISIONS
PrR fOJECT INFORMATION
1. LOCATION/SITE
ADDRESS:
2. DETAILED DESCRIPTION OF PROJECT
REVISIONS:
G A�tP C rih e��
3. CONTRACTORINFORMATION:
STATE of FL REGJCERT. #1 Sr. LUCIE COUNTY CERT. #:
BUSINESS NAME: J�ii�aM ori�9S r-s-F PC y�tic.
QUALIFIERS NAME: Ro bz/-F frl-'X ckoF
ADDRESS: /6(4 .s /- an, ,pi too
CITY: P 5 ( STATE'. L ZIP: 3r a
PHONE (DAYTIME):_'7�a , ' 91=76 ry FAX: — 434 - 7 337
4. OWNERBUHAERINFORMATION:
NAME: q k)
ADDRESS: 9 aJ 0 rc-S- Qr - LN - .
CITY: Ta m (9=-� STATE: G L ZIP: 7 9 r J
PHONE: '',poi a48' FQlzl FAX:
S. AAME CT/ENGINEE7.FOR(MATI N: I C
ADDRESS: Il-ati 5ti/ Yr I as.-e-
CITY: STATE: ZIP: f3IL 41Z PZ/
PHONE'(DAYTIME): - 77-7-.c FAX:. - -
Revised (17=014