HomeMy WebLinkAboutREVISION Bussey FormOFFICE USE ONLY:
DATE FILED:
REVISION FEE:
LOCATION/SITE
ADDRESS:
12375 Skymaster St
PERMIT #
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
DETAILED DESCRIPTION OF PROJECT
REVISIONS:
New product appproval for sliding glass doors
CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #: CGC1519160
BUSINESS NAME: Jackson Construction Group, Inc
QUALIFIERS NAME: Michael Jackson
ADDRESS: 13043 53rd Ct N
CITY: West Palm Beach STATE: FL
PHONE (DAYTIME): 561-308-0730
OWNER/BUILDER INFORMATION:
ST. LUCIE CO CERT. #:
ZIP: 33411
FAX: N/A
NAME: Alexander Bussey
ADDRESS:12375 Skymaster St
CITY: Port St Lucie STATE: FL
PHONE (DAYTIME: 561-762-7559 FAX: N/A
ARCHITECT/ENGINEER INFORMATION:
NAME: N/A
ADDRESS:
CITY:
PHONE (DAYTIME):
SLCCC: 9123109
Revised 06130/17
STATE:
FAX:
ZIP: 34987
ZIP: