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REVISION, SIDING, MOISTURE BARRIER SPECS
OFFICE USE ONLY: DATE FILED: _____________________________ PERMIT # _______________________________ REVISION FEE: ___________________________ RECEIPT # ______________________________ ______________________________________________________________________________________________ PLANNING & DEVELOPMENT SERVICES BUILDING & CODE REGULATION DIVISION 2300 VIRGINIA AVENUE FORT PIERCE, FL 34982-5652 (772) 462-1553 APPLICATION FOR BUILDING PERMIT REVISIONS PROJECT INFORMATION LOCATION/SITE ADDRESS: ___________________________________________________________________________________ ___________________________________________________________________________________ DETAILED DESCRIPTION OF PROJECT REVISIONS: ___________________________________________________________________________________ ___________________________________________________________________________________ CONTRACTOR INFORMATION: STATE of FL REG./CERT. #: ______________________ ST. LUCIE CO CERT. #: ____________ BUSINESS NAME: _________________________________________________________________ QUALIFIERS NAME: ________________________________________________________________ ADDRESS: _______________________________________________________________________ CITY: _______________________ STATE: _______________ ZIP: _______________________ PHONE (DAYTIME): ________________________ FAX: _____________________________ OWNER/BUILDER INFORMATION: NAME: ____________________________________________________________________________ ADDRESS:__________________________________________________________________________ CITY: _____________________________ STATE: __________ ZIP: __________________ PHONE (DAYTIME: ___________________________ FAX: _____________________________ ARCHITECT/ENGINEER INFORMATION: NAME: ____________________________________________________________________________ ADDRESS: _________________________________________________________________________ CITY: _____________________________ STATE: ____________ ZIP: ___________________ PHONE (DAYTIME): ___________________________ FAX: ____________________________ SLCCC: 9/23/09 Revised 06/30/17 6603 S INDIAN RIVER DRIVE PORT SAINT LUCIE, FL CURRENT PERMIT # 2004-0595 REVISED SIDING PRODUCT SPECIFICATIONS AND MOISTURE BARRIER PRODUCT SPECIFICATIONS ADD TO PERMIT - REPAIR DAMAGED AREAS OF STUCCO SOFFIT CGC 1523559 31675 LUXURY RENOVATIONS AND ADDITIONS CHRIS QUINN 2740 SW MARTIN DOWNS BLVD PALM CITY FL 34990 561-719-9709 6603 SIRD LLC C/O KENNETH WURTENBERG 5791B NW 151 ST MIAMI LAKES FL 33014 772-247-4878