HomeMy WebLinkAboutPermit Renewals PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
';COUNTY
� BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE,FL 34982
(772)462-1553 Fax(772)462-1578
PERMIT RENEWAL REQUEST
PERMIT NUMBER: 1705-0292 ADDRESS: 7104 Pacific Ave
I, Roderick Waller ,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 Need more time have electrician extend receptacles
Oj12/2/17
O RBLDR OR CON RACTOR SIGNATURE DATE
Roderick Waller
Print Name
STATE OF FLORIDA
COUNTY OF St Ludo
ACKNOWLEDGED BEFORE ME THIS 2nd DAY OF December 12017
BY Roderick Waller WHO IS PERSONALLY KNOWN TO ME X OR
HJOF
D AS IDENTIFICATION.
STRIDA, t Lucie „
•'•'' SOPHIA HARRIS
\ MY COMMISSION#FF997093
SIGNATU OF NOTA S EXPIRES May 30,2020
(407)398-0153 Flo d&NotarySeN"com
FOR OFFICE USE ONLY:
Number of Open Inspections:
Total Inspections:
(Divide open by total to get%of open inspections)
Percentage:
Original permit fee: x%open = $ Renewal fee
Example: [15 divided by 23=.65(%)] $175(penmit fee)x.65=$113.75(renewal fee)
Revised 7/21/2014