HomeMy WebLinkAboutPermit Renewal Request FILE COPY
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 1018 PERMIT RENEWAL REQUEST
permitting Department
St.Lucie county
PERMIT NUMBER: 1707-0131 ADDRESS: 4860'River Oak Ln.
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
101
O LD NT ACTOR SIGNATURE DATE
Print Name
STATE OF FLORIDA
COUNTYOF g Lvkt°it
ACKNOWLEDGED BEFORE ME THIS DAY OF 20 / D
BY 141-W4I 9L)QV1wcl WHO IS PERSONALLY KNOWN TO ME OR
HAS PROVIDED AS IDENTIFICATION.
STATE OF FLORIDA,County of
TIt;10THY R.011PL LEY !
SIGNATURE OF NOTARY Y h ;x RAY COp.IMISSION�GG 117135
s;r Po' EXPIRES:August 7,2021
ublcUnderwiiers iBonded Thru NotaryPr
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