HomeMy WebLinkAboutPermit Renewal PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
• 2300 VIRGINIA AVE
-- FORT PIERCIJ,FL 34982 RECEIVED
(772)462-1553 Fax(772)462-1578
APR 0 B j018
PERMIT RENEWAL REQUEST Permitting Department
St. Lucie County
PP MIT NUMBER: 9�fl�'d ADDRI°SS_
I, :YYl• - Sjnn ,am requesting that the above permit be renewed. I
understand that I must schedule and pass all required inspections foi the permit to be finaled. Further,I
understand that this is a ONE TEVIE RENEWAL and the permit shall expire should I not receive a
passing inspection during any six month period during the renewal period,rr��.
Justification Q a�b�Q� �1 rG
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OWNE QR CON CTOR SIGNATURE DATM
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print Name
STATE OF FL DA
COUNTY OF �/�-
ACKNOWLF-I)GFABEFORE ME THIS !/ l DAY OF 2Q�t]—
BY {�1 i I` V V 1-! O!J r WHO IS pERSONALLY XNO WN TOME ,OR
HAS PROVIDED
AS
ENTEFICATION.
STA F FLO )AACounty of t4CI%YlTAL
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S NATURE Op'NOTARY - EKPIRFS July 31.2019
FOIA 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)
RLvised7/21M14
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