HomeMy WebLinkAboutMisc Letters PECEI'.' D APP d ?al7
PLANNING AND DEVELOPMEIV 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: 1512-0168 ADDRESS: 10600 S Ocean Dr#901
I, Michael Hei'ssenberg ,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 Condo had concrete work being done that took longer than expected putting a delay on the inspection.
OWNER/BLDR OR COT,1fRAi7,TOR SIGNA DATE
Print Name
STATE OF FLORIDA
COUNTY OF LU 0
ACKNOWLEDGED BEFORE ME THIS I- DAY OF t I 20
BY I ► 11 l.l�G� ' - I J f 0b r `1 WHO IS PERSONALLY KNOWN TOME OR
HAS PROVIDED ` L / / AS IDENTIFICATION.
C.
TE F FLORIDA,County of �T, l 1 `��"`�a.�, HEATHER VIZZO
fd0'TARY PUBLIC
8 7ATE OF FLORIDA
SEAL _.k.�`' '' Camm#FF176266
SIGNATURE OF NOTARY °s _�2,,,,�y
Expires 11/13/2018
-------------------------------------------
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)
I
Revised 7/21/2014