HomeMy WebLinkAboutPermit Renewals To: renewal permit • Page 2 of 2 2017-08-24 16:43:23(GMT) 18666845854 From: Scott Hixon
PLANNING AND DEVELOPMENT SERVICES DEPART .MENT
BUILDING AND CODE REGULATIONS DIVISION
_ 2300 VIRGINIA AVE:
_ - FORT PIERCE,FL 34982
(772)462-1.553 Fax(772)462-1578 r^ �.�•*-
PERMIT RENEWAL REQUEST AUG 12 h,
PEE Y71?7iNG
Sit. Lucie County, FL
PERMIT NUMBER: SLC-1610-0130 ADDRESS: 3354 NW PERIMETER RD
I W S HIXON ,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 R2ENEWAL,and the permit shall expire should I not receive a
passing inspection during any six month period during the renewal period.
Justification REQUESTED TO PROCEED
JULY 28, 2017
OWNER/BLDR OR CONTRACTOR SIGNATURE DATE
W S HIXON
Print Name
STATE OF FLORIDA
COUNTY OF mARTIN
ACKNOXVLEDGED BEFORE ME THIS 28TH DAY OF JULY -- 2017
BY KATHLEEN MOUTRAN WHO IS PERSONALLY KNOWN TO NIE X ,OR
HAS PROVIDr.D AS IDENTIFICATION.
KATHLEEN MOUTR7AN
STATE OF FLORIDA,Count of MARTIN
y MY COMMISS10 #Fr-899W9
{ 'o ` •,a EXPIRES July 13,2019
'��J 1407)"844,3 FWft%4atzryBeMse.CIDr:
YMP
SI� OF NOTARY SEAL.
FOR OFFICE USE ONLY:
Number of Open Inspections:
Total Inspections: _
(Divide open by total to bet%of open inspections)
Percentage:
Original permit fee:_ _ x%open =. $-_-_Renewal fee
Example: J15 divided by 23=.65(%)] $175(permit fee)x-65=$l 13.75(renewal fee)
Revised 7!21(2014