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PL-ANNIh[G AND DDEPARTMENT'` BUILDING AND CODE REGULATI©NS C E I V E D - 2300 VIRGIIyIA A'VE • -- FO�Yr PIFI2C�,FL 3498 (T72j 462-1553 Fax(772)462157$ APR 12 X018 ST. Lucie County, Permitting PEf MT RENEWAL REQUES. i P1;PMTI 'NUMMEL 17.09 0489 . = Anv zEss 7104 Fenny Shyan;Wottczak am requestiing that the above permit be renewed I: .understand that I.must schedule and:pass all required wspections rfor the:;permit to be finale: Further,I understand that;;tlus is a;ONE,TII°IE RENEWAL aindaheperMl shall_expueshould T not-xece�ve:a. pass tng inspection during any s ;inonth.penod during the renewal period: Justification Homeowner was not W16 to:take:offyirofk OWNS „LDR OR'C T ClORSIGNATURE :...... . . . .. 9hyan UVo�tczak PftntiName, ' i STATE OF 1I.ORIDA COUNTX0 Jl�e)rga,. ACKNOWLEDGEDBEFORE ME THIS 1 j` DAY>OF 20 g yU 7 GZ. lG y4'I30'IS,PERSOAIALLI';ICi�TQWIV ST.` bzolCountif lhnf,�?sh l:tfR-F �;rPn _ CAT•ilE lEE Sl U4G - °. • a �pf2`(�I}Xw S13lCOtF(A'f� . � 't' Carmsson��iG4i;S3xt )F.OR OFFICE,USR:ONLY? ' `Number of Open'?Tn'specttons _,- Total Inspec{tons (D- 'd open by total to get%a,Qf.open°inspections) Percentage:,. Original peraut fed..: � �-%-open.=; $ :: .. .:Ren�wat=Tee Example [IS divided by 23 65(fo)] ,$17$(permz�fee)x,65 $113 75(Fenevral fee) Rey_sed 721�Z014 I k