HomeMy WebLinkAboutPermit Renewals I'
Dec. 13. 2017 '12; 50PM Barker Air Condition 7725625340 No, 6920 P. 2
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PLANNING AND DEVELOPN MNT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DI IISION
• 2300 VIRGINIA AVE
FORT PIERCE,FL 3„4982
(772)462-1553 Fax(772)462-1578
` PERMIT RENEWAL�REQUEST
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� �--I PERMIT NUMBER: �1� 1 ADDRESS: II
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am requesting that the above permit be renewed. I
understand that I must schedule and pass all required inspections fox-the permit to be finaled. Further, I
understand that this is a ONE TRUE RENEWAL and the permit shalll expire should I not receive a
passing inspection duriug any six month period during the renewal period.
Justification .
RlBLD _ R CO RaACTOR DATE
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Print Name
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STATE OF FLORIDA
COUNTYOF � iI
ACKNOWLEDGED BEFORE ME THIS DAY Of �,_ e eJ)n Lq.2 ll 20' 1
By Mak`'XL M R-["A >~ (C, WHO IS PERSONALLY KNOWN TO IME
HAS PROVIDED ASI IDENTIFICATION,
VOF FLORIDA, ounty of —�nW CI�`\ iJ C=✓ BARBARA ANN MURRAY
Notary Public-State of Florida
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IGNATURE OF NOTARY SECommission#FF 231535
RI. ;'�+ * °-
j n My Comm,Expires Aug 16.2019
Bonded throw ssn
„ , I Ah National Notary A .
FOR OFFICI;USE ONLY:
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Number of Open Inspections: ,
Total Inspections:
(Divide open by total to get%of open inspections)
Percentage:
Original permit fee: x%open = $ Renewal fee li
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Example; [15 divided by 23=.65(%)] $175(permit fee)x.65—$113-75(renewal fee) i
Remised 7/21014 I'
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