HomeMy WebLinkAboutREVISIONSCANNED
BY
OFFICE USE ONLY: St. Lucie County
DATE FILED:
REVISION FEE: / D D
LOCATION/SITE
PERMIT # 1 g 03 -0 6 G (7.
RECEIPT #
PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE REGULATION DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982.5652
(772)462.1553
APPLICATION FOR BUILDING PERU F EVISION
PROJECT INFORMATION
ADDRESS: 7 i -z i 5 us H (-, Y l i°a SI- G"(- 11- 46
DETAILED DESCRIPTION OF PROJECT
REVISIONS:
C1ovNo�t �b (310C,� 'few. 17\s"^\"Vv�
CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #: C6L ( S 2 '� 2 (o i
BUSINESS NAME: ULA- lj\".k
QUALIFIERS NAME: ti l
ADDRESS: lb%`'7 $w
ST. LUCIE CO CERT. #:
CITY: ' �4VII�' STATE:
PHONE (DAYTIME):'??Z 26o - S75 �F- FAX:
ONVNER/BUILDER INFORMATION:
ZIP:
NAME: "Y5 ck oo ~ A--Ac-4"� 4 �-\ c
ADDRESS: 721 1--0 S ; 5 Irt'ti)f 1
CITY: (9on)^ S'tr L U k5 L STATE: ZIP: S I ?-
PHONE (DAYTIME: 9? 2 - 2e D - 5 75 ) FAX:
ARCHITECT/ENGINEER INFORMATION:
NAME: G
ADDRESS: _
CITY:
aIV
STATE: _
PHONE (DAYTIME): 2�';-
SLCCC: 9123109
Revised 06130117
FAX:
ZIP:
OCT 18 2019
Permitting Department
St. Lucie County, FL