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APPLICATION FOR PERMIT REVISION
OFFICE USE ONLY: DATE FILED: REVISION FEE: 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 LOCATION/SITE ADDRESS: (totmT 1119 NETTLES BLVD, JENSEN BEACH, FL 34957/ DETAILED DESCRIPTION -OF PROJECT REVISIONS: FURNISH AND INSTALLING 1 PC. NEW 9,000 LB CAPACITY BOAT LIFT. CONTRACTOR INFORMATION: STATE of FL REG./CERT. #: SCC131151026 BUSINESS NAME: WILCO CONSTRUCTION INC QUALIFIERS NAME: R. WILLIAMS ADDRESS: 10751 ORANGE AVE CITY: FT PIERCE STATE: FL PHONE (DAYTIME): 772-460-6928 OWNER/BUILDER INFORMATION: NAME: DUPEE ADDRESS:1119 NETTLES BLVD IN ST. LUCIE CO CERT. #: 29115 ZIP: 34945 FAX: 772-460-6929 CITY: JENSEN BEACH STATE: FL ZIP: 34957 PHONE (DAYTIME: 843-241-0491 FAX: N/A ARCHITECT/ENGINEER INFORMATION: NAME: ROGER BARBER ADDRESS: 8528 SW KANSAS AVE CITY: STUART PHONE (DAYTIME): SLCCC. 9123109 Revised 06130117 STATE: FL ZIP: 34997 FAX: i DPi, 1 ty i i1 � (D m TI 5 1/1