HomeMy WebLinkAboutPermit Renewals Nov 08 17 09:50a p.1
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCF,FL 34982
(772)462-1553 Fax(772)462-1578 �a�.,.€ '�L „d
PERMIT RENEWAL REQUEST NOV Q 7 2017
PER'1,17TING
TSt. Lucie County, FL
PERMIT NUMBER: '""�o���"�o ADDRESS:�JO J•ORO f 1D:. �Q} Iio0�1 V� ✓/1 [P1/ 1, STI
I, �t� ►">�Pa'� �pe2 I�iTLC,0nO►-"-0r3g04 SerJlee , LLC,
am requesting that the above permit be renewed. I
understand that 1 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 l hC 1Q. Co" PV-t cj_Va<'4' b.y 0.7p lmorp1 V TS'sls G-n+
W'M'.0 0+ tpa5Scho1
OWNER/BLDR OR CONTRACTOR SIGNATURE DATE
B1 Y-der
Print Name
STATE OF FLORIDA
COUNTY OF_? _. �.A.l O.d e, 1 111 J
ACKNOWLEDGED BEFORE
• ME THIS � DAY OF �}? 1 yl ba ` .20 Irl
BY' Vl 0 8)P-� � w iO IS PERSONALLY K)\O '. TOME ,OR
HAS PROVIDED AS IDENTIFICATION.
4A!Ti
TEOF FLORI A,County of `1 C 1 �� '�'
Y �LtC(.� ""^'�:: LINDA MARIE t30UCHAHD
,., a - MYCOMMISS101Va1`FF12552H
URE OFNOTARY '
SEAL ,��✓" EXPIRES May 21,2018
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FOR OFFICE USE ONLY:
Number of Open Inspections:
Total Inspections:
(Divide open by total to set%of open inspections)
Percentage:
Original permit fee: x%open = S Renewal fee
Example: [15 divided by 23=.65(%)] S1 75(permit fee)x.65=$113.75(renewal fee)
Revised 7,121 M- 14