HomeMy WebLinkAboutRevisions OFFICE USE ONLY:
DATE FILED: 0 .1 PERMIT# lx� 1 )
REVISION FEE: Do RECEIPT# 0 Rfl!R
PLANNING & DEVELOPMENT SERVICES
BUILDING&CODE REGULATION DIVISION
iCOUNTY I
A 2300 VIRGINIA AVENUE
IF L 0 R 1 D
FORT PIERCE,FL 34982-5652
(772)462-1553 FAX(772)462-1578
APPLICATION FOR BUILDING PERMIT REVISIONS
PROJECT INFORMATION
I. LOCATION/SITE
ADDRESS: 131✓v d
2. DETAILED DESCRIPTION OF PROJECT
REVISIONS:
e was /t/a 1v7ckrk-c,,4 o ,7 Oraw lij
3. CONTRACTOR INFORMATION:
STATE of FL REG./CERT.#: ST. LUCIE COUNTY CERT.#: '2(0030
BUSINESS NAME: ALL 4-T=!Z R EACH C E
QUALIFIERS NAME: <
ADDRESS: 7(r' o 3 o Ct lloot -
CITY: pl-5.1, STATE: ZIP: T Z—9—T3
PHONE(DAYTIME): 77; is- FAX: 77;z. 7 92 1?;L 93
4. OWNER/BUILDER INFORMATION:
NAME:
ADDRESS:
CITY: STATE: ZIP:
PHONE: FAX:
5. ARCHITECT/ENGINEER INFORMATION:
NAME:
ADDRESS:
CITY: STATE: ZIP:
PHONE(DAYTIME): FAX:
Revised 07122,2014
RFViSION
MWIIIIIIIIIn V w
t
�7
r _
i
• �i
i � J