HomeMy WebLinkAboutREVISIONOFFICE USE ONLY: /�( SCANNED
DATE FILED: i l.G� I 1 V BY PERMIT #
_ —� St. Lucie County
REVISION FEE: � � RECEIPT #
PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE REGULATION DIVISION
2300 , F AVENUE
FORT PIERCE, FL 34982.5652 � '� � y ,
(772)462-1553
APPLICATION FOR BUILDING PERMIT R I
PROJECT INFORMATION
LOCATION/SITE 3
ADDRESS: � �'� 5� G s moop)
DETAILED DESCRIPTION OF PROJECT
:Fe c-e (cr 41A—e.1
CONTRACTOR INFORMATION:
STATE of FL REG./CI
BUSINESS NAME: .
QUALIFIERS NAME:
ADDRESS:
CITY:
PHONE (DAYTIME):
C(Q1�
STATE:
OWNERBUILDER INFORMATION:
ST. LUCIE CO CERT. #:
FAX:
ZIP:
NAME: la�il 4�
ADDRES ' C+ m t
CITY:' G STATE: ZIP:
PHONE (DA IME: FAX:
ARCIIITECT/ENGINEER INFORMATION:
NAME:
ADDRESS:
CITY:
PHONE (DAYTIME):
SLCCC: 9123109
Revised 06130117
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FAX:
ZIP: