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PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
- BUILDING AND CODE REGULATIONS DIVISION
+ 2300 VIRGINIA AVE
FORT PIERCE,FL 2 E i�IVED
(772)462-1553 Fax(772)2)4 462-1578
PERMIT RENEWAL REQUEST APR 3 201
PER."AITTiNG
St. Lucie County, FL
PERMITNUMBER: 1511-0145 ADDRESS: 5803 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 We ran into issues with the customer's availability during the final inspection
We are requesting the permit be renewed for 6 months so we can get this closed out
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OWNERIBLbR OR CONTRACTOR SIGNATURE — DA
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Print Nme
STATE OF FLORIDA
COUNTY OF
ACKNOWLEDGED BEFORE ME THIS (` DAY OF !<i .20 }
BY S!Ja_y5 t«2_ l`--A w-A•t AX WHO IS PERSONALLY KNOWN TO ME ,OR
HAS PROVIDED AS IDENTIFICATION.
STATE OF FLO ounty of f $f JONATHON ALLEN THOMAS
SPRY sow NOTARY PUBLIC
STATE OF FLORIDA
S F , �Comm#FF055234
7NOE AI11' Expires 9!18!2017
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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(°fo)] $175(permit fee)x.65=$113.75(renewal fee)
Revised 7/21/2014