HomeMy WebLinkAboutPermit Renewals NOV-02-2017 10:13 From: 407 3595478 To:17724621578 Page:1/2
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, y„_n PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
I row IgUILDING AND CODE REGULATIONS DIVISION
NTY 2300 VIRGINIA AVE
--- FORT PIERCC,N7,,34992
(772)462-1553 Fax(772)462-1578 1,
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PERMIT RENEWAI.REQUEST
PERMIT NUMBER: ADDRESS: 05
am requesting that the above permit berenewed. i
understand tha l must schedule and pass all required inspections For the permit to be finaled. Further, I
understand that this is a ONE TIIVYE RENEWAL and the permit shall expire should 1"not receive a
passing inspection during any six month period during the renewal period.
Justification
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10-31-2017..
OWNE R/01.0 OR CONTRACTOR SIGNAIVRE DATE
GARY WEST
Print Name
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STATE OF FI,ORI
COUNTY OF
ACKNOWLEDGED BEFOM ME THIS DAY OF
BY (SQ-,-q We S'f WHO 1S PERSONALLY KNOWN TO ME_V ,OR. '
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HAS PROVIDED AS I ENTIFICATION.
OF FLORID o �"^� "" C)AVID EDWARD CRAIG
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MY COMMISSION#FF126748
ATURF OF 58A1, EXPIRE
June 7,201 B
(407)age also F DOINnte Scrvice.anrA
FOR OFFICE USE ONLY:
Number of Opcn Inspections: 2
Total Inspections: 2
(Divide open by total to get%of open inspections)
Percentage:
Original permit fee: x%open $ Renewal fee
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C3xample: [15 divided by 23=.65(%)] $175(permit fee)x-65=$113.75(renewal fee)
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Revised 7/21/2014
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