HomeMy WebLinkAboutPermit Renewals s
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
L"6101 2300 VIRGINIA AVE
FORT PIERCE,FL 34982 RECEIVED
(772)462-1553 Fax(772)462-1578
APR 13 2018
PERMIT RENEWAL REQUES
j
ST. Lucie county, Permitting
PE NUMBER. SLC/16001-0290 ADDRESS: 105 SE SELVA CT
I )C—f 411-,� 6e IW50� ,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 durin any si month period during the renewal period.
Justification
OWNE"LD _ NT CTOR SIGNATURE DATE
RICHARD LEVINSON
Print Name
STATE OF FLORWA
COUNTY OF V
ACKNOWLEDGED BEFORE ME THIS DAY OF ADn( 20��
BY 'R1 a rd Le VjWdn WHO IS PERSONALLY KNOWN TO ME OR
HAS PROVIDED AS IDENTIFICATION.
E OF FLO A,Co ty of rnr�(Qt'G� • �''' •' PATTIE JQ NETTLES
p' h�:
. My COMMISSION#FF952984
o;,,a EXPIPES January 21,2020
I NATURE OTARY SE4(407i ay8•°153 rluridaNMaryS#fv-I-st—
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FOR OFFICE USE ONLY:
Number of Open Inspections:
Total Inspections:
(Divide open by total to get%of open inspections)
Percentage: .4-157.—
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