HomeMy WebLinkAboutPermit Renewals From Team K5 1.407.469.3499 Fri Mar 31 10:28:58 2017 MDT Page 2 of 2
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PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE RE'GULATIONS DIVICSION
2300 VIRGINIA AVE
�_...,......... FORT PIERCE,FL 34982
(772)462.1553 Fax(772)462.1578
PERMIT RENEWAL REQUEST
PERMIT NUMBER: 1608-0139 ADDRESS: 8111 S Indian River Dr.
I, Boysie Ramdial 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.
Justification Customer had scheduling conflicts when we attemted to schedule the final
inspection
03/31/2017
OWN ER/BLDR 0 NTRACTOR NATURE DATE
Boysie Ramdial
Print Name
STATE OF FLORIDPy
COUNTY OF ST LU
ACKNOWLEDGED BEFORE ME THIS 3IL DAY OF Y y otyz—v-v
BY x7t ge',e- P,4,V14W\ WHO IS PERSONALLY KNOWN TOME >s�—_,OR
HAS PROVIDED AS IDENTIFICATION,
STATE 0 RI DA,County ofJONATHON ALLEN THOMAS
�o soy, NOTARY PUBLIC
a STATE OF FLORIDA
SIGN RY 5E Comm#FF065234
1 Expires 9/1612017
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