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HomeMy WebLinkAboutPermit Renewals PLANNING AND DEVELOPMENT SERVICES DEPARTMENT © - - BUILDING AND CODE REGULATIONS DIVISION 2300 VIRGINIA AVE FORT PIERCE,FL 34982 (772)462-1553 Fax(772)462-1578 PERMIT RENEWAL REQUEST PERMIT NUMBER: SLC 1511-0254 ADDRESS: 494 THAMES BLUFF RDG I Richard Levinson ,am requesting that the above permit be renewed. I understand that I must schedule and pass all required inspections for the permit to be finaled. Further, I understand that this is a ONE TIME RENEWAL and the permit shall expire should I not receive a passing inspection during any six month period during the renewal period. u Nno �dy meowner was not able to schedule the re-i�renew�aof section in the time alloted for the Permit is to schedule the re-inspection upon th �Perrn�it ��� OW R O C R SIGNATURE DATE Print Name STATE OF FLORIDA���� COUNTY OF a ACKNOW,.LEEDGED BEF1ORE ME THIS �5 DAY OF r�`'=� 201 BY �i IN`olr�/ Lazm s 0/1 WHO IS PERSONALLY KNOWN TO ME OR HAS PROVIDED AS IDENTIFICATION. STATF OF FL RIDA,County of SHERIFAWHYTE MY ComMISSION;#FF 065032 EXPIRES:October 21,2017 NA OF NOTARY SEA fl1�4°' Bonded l hru Notary Public Undenvriters --------------------------------------------------------------------------------------------------------------------------------------------------------- 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