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REVISION
OFFICE USE ONLY: DATE FILED: REVISION FEE: LOCATION/SITE ADDRESS: SCANNED BY St. Lucie county PERMIT# j--)0-1-6LloV RECEIPT # PLANNING & DEVELOPMENT SERVICES BUILDING & CODE REGULATION DIVISION 2300 VIRGINIA AVENUE FORT PIERCE, FL 34982-5652 (772) 462-1553 APPLICATION FOR BUILDING PERMIT REVISIONS PROJECT INFORMATION DETAILED DESCRIPTION OF PROJECT REVISIONS: V-k- CONTRACTOR INFORMATION: RECEIVED SEP 2 2 2017 PERIMITTING St. Lucie County, FL STATE ofFLREG./CERT. #: CJ3C-10,�S Fr ST. LUCIE CO CERT. #: BUSINESS NAME: j5b!b0z QUALIFIERS NAME: ADDRESS: CITY: STATE: PHONE (DAYTIME): -7-7 OL - b-7 9- - Fol j!j FAX: OWNER/BUI-LDER INFORMATION: NAME: CITY: PHONE (DAYTIME: STATE: ARCHITECT/ENGINEER INFORMATION: NAME: ADDRESS: CITY: PHONE (DAYTIME): SLCCC.- 9123109 Revised 06130117 STATE: FAX: FAX: ZIP: P"p ZIP: