HomeMy WebLinkAboutPermit Renewals From Team K5 1.407.469.3499 Wed Feb 15 13:33:19 2017 MST Page 2 of 2
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND-CODE REGULATIONS DIVISION
-� 2300 VIRGINIA AVE,
FORT PIERCE,FL 34982
RECEIVED
(772)462-1553 Fax(772)462-1578
PERMIT RENEWAL REQUEST FSB 16 2017
PERGJIITTHNG
St. Lucie County, FL
PERMIT NUMBER: I� " b � �J7 ADDRESS: 2771 Coolidge Rd.
I Boysie Rarndial _,am requesting that the above permit be renewed. I
understand that I must schedule and pass all required inspections for the permit to be tinated. Further, I
understated that this is a ONE TIME RENEWAL and the permit shall expire should I not receive a
passing inspection durhig any six month period during the renewal period.
Justification The customer left town prior to us completing the final inspection.The customer
will be back in town on Mar. 1, 2017.
2115/17
OWNER/RLDR OR CONTRACTOR SIGNATURE DATE
Boysie Rarndial
Print Name
STATE OF FLORIDA
COUNTY OF : E
ACKNOWLEDGED BEFORE ME THIS V J DAX OF ��� 20
BY 'WHO'WHO IS PERSONALLY KNOWN TO ME_'�OR
HAS PROVIDED AS MENTIFICATT
JONA ALLEN THOMAS
NOTARY PUBLIC
STATE Caen STATE OF FLORIDA
o Cornet#PFp55234
SIG TURF Y
5 si CE Expires 8!1812017
--------------------------------------------- ---__w__---------_-_------- .--------_--------------__ ------
FOR OFFICE USE ONLY:
Number of Open Inspections:
Total Inspections:
(Divide open by total to get%of open inspections)
Percentage:
Original permit fee: x%open = $ Renewal fee
Example: [15 divided by 23=.65(%)] $175(permit fee)x.65=$113.75(renewal fee)
Revised 7/21/2014
I