HomeMy WebLinkAboutPermit Renewals PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
1' E BUILDING AND CODE REGULATIONS DIVISION
.im-1 2300 VIRGINIA AVE t�om_'.^
FORT PIERCE,FL 34982 � �• E D
(772)462-1553 Fax(772)462-1578
NOV 17 2017
PERMIT RENEWAL REQUEST PERMITTING
5t. Lucie County, FL
PERMIT NUMBER: /�[ (lT ADDRESS: V ! ��C b' t
- w1f F/
I,
co .SC.hbGv ,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
OWNEWBLDIi'OR CQN'I1" - SIGNATUREATE
Print Name
STATE OF FLORIDA
COUNTY OF
ACKNOWLEDGED 13EFORE ME THIS DAY OF ,20
BY �,(� J ' Q�+Xc1 WHO IS PERSONALLY KNOWN TO Iv1E ,OR
HAS PROVIDED 'r L OL S 70C) I (D Zq. -0 AS IDENTIFICATION.
ST F FLORIDA,County of o�`,`µ'v n�e��� PATRICIA C BISSETT
Notary Public-State of Florida
Commisslon#FF 213082
GNAT E OF SE No��o foo-°�' My Comm.Expires Mar 24,2019
Bonded through National Notary Assn.
FOR OFFICE USE ONLY:
Number of Open Inspections:
Total Inspections:
(Divide open by total to get%of open inspections)
Percentage:
Original permit fec: x%open = $ _Renewal fee
Example: 115 divided by 23=.65(%)] $175(permit fee)x.65=$113.75(renewal fee)
Revised 7/21/2014