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2104-0648 revision
OFFICE USE ONLY: DATE FILED: REVISION FEE: PERMIT# 21G44)648 RECEIPT # PLANNING & DEVELOPMENT SERVICES BUILDING & CODE REGULATION DMSION 2300 VIRGINIA AVENUE FORT PIERCE, FL 34982-5652 (772)462-1553 APPLICATION FOR BUILDING PERMIT REVISIONS PROJECT INFORMATION LOCATION/SITE ADDRESS: 7401 SAN CARLOS DR, FORT PIERCE FL 34951 DETAILED DESCRIPTION OF PROJECT REVISIONS: ADDING MAXIM POLYSKYLIGR TO PERMIT (NO"18-1120.0 CONTRACTOR INFORMATION: STATE of FL REG./CERT. #: 1325895 BUSINESS NAME,: J.A TAYLOR ROOFING INC QUALIFIERSNAME: KYLEMITE ADDRESS: 302 MELTON DR CITY: FORTPIERCE STATE: PHONE (DAYTIME): 772-466-4040 OWNER/BUILDER INFORMATION: ST. LUCIE CO CERT. #: 23018 FL ZIP: U982 FAX: "2468-8387 NAME: NIA ADDRESS: CITY: STATE: ZIP: PHONE (DAYTIME: FAX: ARCHITECT/ENGINEER INFORMATION: NAME: WA ADDRESS: CITY: PHONE (DAYTIME): SLCCC: 9123109 Revised 06130117 FAX: MIA