HomeMy WebLinkAboutPermit Renewals 03/01/2018 08:59 Office (FAX) P.002/002
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
4 BUILDING AND CODE REGULATIONS DIVISION
■•
2300 VIRGINIA AVE
FORT PIERCE,FL 34982 RECEIVED
(772)462-1553 Frac(772)462-1578
MAR 01 2018
PERMIT RENEWAL REQUEST
ST. Lucie County, Permitting
PERMIT NUMBER: SLC 17030477 ADDRESS: 1603 N 33 ST
1, '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. Farther,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
2-27-2018
OW-16,R/BLDR¢R CONTRACTOR SIGNATURE DATE
Joseph Herrmann
Print Name
STATE OF FLORWn
COUNTY OF t1
ACKNOWLEDGED BEFORE ME THIS x4;( DAY OF 20
BY WHO IS PERSONALLY KNOWN TO ME --- OR
HAS PROVIDED AS IDENTIFICATION.
STATE OF A,County of Palm Beach
CARO �...g
LE A PAUc. 'L'-q !
t MY COMMISSION tl HFyj�TG
SIGNATURE OF NOTAR SEAL I<ar s9i.• Expi May 10,2020
0 43 P�orb�Mots
ry8ervrce.�,,,
FOR OFFICE USE ONLY: ���•�•�____�� � �W .... ....
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(permit fee)x.65-$113.75(renewal fee)
Revised 7/21/2014