HomeMy WebLinkAboutPermit Renewal 04/06/2018 07:09AM 7724612036 Steve Smith A/C PAGE 01/02
PLANNING AND DEVELOPMENT SERVICES DEPART-NIENT
BUILDING AND CODE REGULATIONS DIVISION
2300 YIRGEYIA AVE RECEIVED
JFOZ27C PIlE)EiCE1 k L 34982
(772)462-1553 Fax(772)462-1578
APR 0 6 2018
PERMIT RENEWAL,REQUEST ST. Lucie County, Permitting
PERMI NUMBER: ADDRESS: 'J-7, ItY�J
i, am requesting that the above permit be renewed. I
uz1 erstand that I must schedule and pass all required inspections for the permit to be fl aled. 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 r newalperiog.
Justification 'z/1 �'
OWNER/Bf,DR QR CONTRACTOR SIGNATURE DATE
Print Name
STATE OF FLORIDA
COUNTY OF �T- ULtCtfZ�)
ACKNOWLEDGEDBEFORE ME THIS DAY OF t f 70 I
BY J �C• 5�" (r WHO ISS PERSONALLY KNOWN TO ME OR
HAS PROVIDED -t ( rG1 �3 UC AS IDENTIFICATION.
STATE OF FLORIDA,County of �T• 1, � __ .immiw A Reid
NOTARYPUBUC
jSl ARY STATE OR FLORIDA
E1pkea 7127/=
F>FIClE 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 by23=.65(%)] S175(pennit fee)x.65=5113.75(renewal fee)
Revised 7/213014