HomeMy WebLinkAboutPermit Renewal request FILE C V
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
_ FORT PIERCE,FL 34982
(772)462-1553 Fax(772)462-1578
RECEIVED
MAR 14 1U16 PERMIT RENEWAL REQUEST
Permitting Departmen!
St.Lucie count'
PERMIT NUMBER: 1707-0246 ADDRESS: 5857 Sun berry Cir. Fort Pierce, FL 34951
I Raquel Swanner ,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 We have been unable to contact the customer to schedule the service
OWNE DR a;NT�PACTOR SIGNATURE tATE
Print Name
STATE OF FLORIDA
COUNTY OF
ACKNOWLEDGED BEFORE ME THIS J DAY OF ! r`O`✓ 120 I
BY gastro JW&om'y- WHO IS PERSONALLY KNOWN TO ME 'D OR
HAS PROVIDED AS IDENTIFICATION.
t j "'•• TItv10THY R.01MALLEY
STATE OF FLORIDA,County of
my C0j,VjjSSIOh!#GG 117135
SIGNATURE OF NOTARY SNi�
otary Public Underwriters C
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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(permit fee)x.65=$113.75 (renewal fee)
Revised 7/21/2014