HomeMy WebLinkAboutREVISION,/FFICE USE ONLY:
DATE FILED:
REVISION FEE: �% ii 0
PERMIT#
RECEIPT# Js
PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE REGULATION DIVISION
2300 VIRGINIA AVENUE
SCANNED FORT PIERCE, FL 34982.5652 RFVISION
BY (772)462.1553
St. Lucie County APPLICATION FOR BUILDING PERMIT REVISIONS
PROJECT INFORMATION SCANNED
LOCATION/SITE BY
avt St. Luce
ADDRESS: County
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DETAILED DESCRIPTION OF PROJECT
REVISIONS:
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CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #: ST. LUCIE CO CERT. #: 'Z S Y 5 9
BUSINESS NAME: O aL,Ak <
QUALIFIERS NAME: D
ADDRESS: y / 3) S c^r_/_
CITY: F � r fi r. t..,, STATE:
PHONE (DAYTIME): `'t 6 S '?N'
OWNER/BUILDER INFORMATION:
NAME: Qg�•'aI1 "Rh.1 Co, r7
CITY: STATE:
PHONE (DAYTIME:
I_\ as) I I Y I xWkWhI_ _ 'l hI I au_:_ 4 41
NAME:
ADDRESS: 6
CITY: F n .STATE:
PHONE (DAYTIME): 1 L
SLCCC: 9123109
Revised 06130117
_ ZIP: T`l-lL'y
FAX: Vg:-
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ZIP:
FAX:
"ZIP: `3 V '+
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