HomeMy WebLinkAboutREVISIONSOFFICE USE ONLY:
DATE FILED: a' I II
REVISION FEE:
PERMIT # 1�1 1 V
RECEIPT #
PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE REGULATION DIVISION
2300 VIRGINIA AVENUE / RECEIVED
SCANNED FORT PIERCE, FL 34982.5652
BY (772)462.1553 FEB 0 7 2018
4. Lucie County
APPLICATION FOR BUILDING PERMIT REVISIO $T. Lucie county, Permitting
PROJECT INFORMATION
LOCATION/SITE
ADDRESS: .
DETAILED DESCRIPTION OF PROJECT
REVISIONS:
CONTRACTOR INFORMATION:
STATE of FL REG./CI
BUSINESS NAME:
QUALIFIERS NAME:
OWNER/BUILDER INFORMATION:
NAME:
CITY:
PHONE (DAYTIME:
STATE:
ARCHITECT/ENGINEER INFORMATION:
FAX:
ADDRESS: `)Qg ( SF CSC � �,?,1y oK S.ut
CITY: '5uay-- STATE: Vj
PHONE (DAYTIME):'171a-29p-Lltoo I FAX:
SLCCC: 9123109
Revised 06130117
ZIP:
ZIP:
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