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DAVIS02 REVISION
OFFICE USE ONLY: DATE FILED: REVISION FEE: PERMIT # 2107-0802 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: 100 BEDFORD, FT PIERCE, FL 34946 DETAILED DESCRIPTION OF PROJECT REVISIONS: CHANGING MATERIALS FROM WIP100 UNDERLAYMENTS 6785.1 TO Weathermaster 200 peel n stick - Florida Building Code Approved - FL 17322 CONTRACTOR INFORMATION: STATE of FL REG./CERT. #: CCC1330395 ST. LUCIE CO CERT. #: BUSINESS NAME: ROOFING & RECONSTRUCTION CONTRACTORS OF AMERICA, LLC QUALIFIERS NAME: DONALD HAIGHT ADDRESS: 1951 J & C BLVD CITY: NAPLES STATE: FL ZIP. 34109 PHONE (DAYTIME): 239-449-6301 FAX: OWNER/BUILDER INFORMATION: NAME: ANNIE DAVIS ADDRESS: 100 BEDFORD, CITY: FT PIERCE PHONE (DAYTIME: 772-801-4900 STATE: FL ARCHITECT/ENGINEER INFORMATION: NAME: ADDRESS: CITY: PHONE (DAYTIME): SLCCC: 9123109 Revised 06130/17 STATE: FAX: FAX: ZIP: 34946 ZIP: