HomeMy WebLinkAboutREVISIONSOFFICE USE ONLY:
DATE FILED:
REVISION FEE:
PERMIT# 110�jn-690:j
RECEIPT #
PLANNING & DEVELOPMENT SERVICES
SCANNED BUILDING & CODE REGULATION DIVISION
2300 VIRGINIA AVENUE RECEIVED
BY FORT PIERCE, FL 34982-5652
-t Lucie County (772) 462-1553 SEP 2 2 2017
PERMITTIN�
APPLICATION FOR BUILDING PERMIT REVISIONS St. Lucie County, FL
PROJECT INFORMATION
LOCATION/SITE
ADDRESS:
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DETAILED DESCRIPTION OF PROJI�CT
REVISIONS:
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CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #: at-1 ST. LUCIE CO CERT. #:
BUSINESSNAME: j%jp0njN
QUALIFIERSNAME: -��u,54jn
ADDRESS: jb�R-)'5 C, Ar-eQ,� 'GWV�
CITY: :5�n5,ea STATE: ZIP: -N
PHONE (DAYTIME): -77,q Wg'- 9,21 Iq FAX:
OWNER/BUILDER INFORMATION:
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CITY:
PHONE (DAYTIME:
STATE:
ARCHITECT/ENGINEER INFORMATION:
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CITY:
PHONE (DAYTIME):
SLCCC 9123109
Revised 0613 0/17
STATE:
FAX:
FAX:
VAI9
ZIP: