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HomeMy WebLinkAboutRevision request form 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 SLC- 2003-0627 10102 South Ocean Drive, unit 206a The SGD header was found to be hollow. Digitally signed plans for the repair are attached. SCC131151738 22928 Max Guard Hurricane Windows Ronald Heath 2253 Vista Pkwy, Ste 12 West Palm Beach FL 33411 561-276-7100 Donna Lierz 10102 South Ocean Drive, unit 206a Jensen Beach FL 34597 1 (704) 408-3834 Specialty Engineering Consultants 1599 SW 30th Ave #20 Boynton Beach FL 33426 (561) 752-5440