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DATE FILED: _____________________________ PERMIT # _______________________________
REVISION FEE: ___________________________ RECEIPT # ______________________________
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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:
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DETAILED DESCRIPTION OF PROJECT
REVISIONS:
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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
13605 S Indian River DR, Jensen Beach, FL 34957
Remove and replace (7) Single Hung windows and (1) Horizontal Roller (revised floor plan- circled the windows we are doing and put an X
through the ones we are not doing anymore.) Also, size change in windows #12, #13 and #15.
30514
Gilmour Window & Door
Mathew Gilmour
1371 SE Vestridge Lane
Port St Lucie FL 34952
772-209-8481
Natasha Jordan
13605 S Indian River DR
Jensen Beach FL 34957