HomeMy WebLinkAboutPermit Renewals PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
- BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE,FL 2)34982
462 (R EC E
(772)462-1553 Fax(772)462-1578 ,! R
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PERMIT RENEWAL REQU ST APR 1 7 ; ';
ST. Lucie County, Permit«;.,,,
PERMIT NUMBER:�l �J�Q,5 DRESS:���� KU a-)CJSTL)o�
I, VV-)I111 C ,am requesting that the above permit be renewed. I
understand that FYnust 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_ *}io
OWNE"LDR OR CONTRACTOR SIGNATURE DA
Print Name
STATE OF FLORI A
COUNTY OF
ACKNOWLEDGED BEFORE ME THIS 1 ! L DAY OF 20-0—
BY �M 1 C!� �'Q l tQ�r%V WHO IS PERSONALLY KNOWN TOME.OR
HAS PROVIDED �L V�--- AS IDENTIFICATION.
STATE O FLORI County f
cuk- U 0,If-,i
SIGNATURE OF OTARY SEAL
--------------
FOR OFFICE USE ONLY:
Number of Open Inspections: KA REN S. N I E L S E N
Total Inspections: _;'"p
Commission tt FF 1 15G37
(Divide open by total to get%of open inspections) • :�" .' My Commission Expires
Percentage: l `
_ �, ^:: :.;,. June 12, 2018
Original permit fee: x%open = $ ��j. Renewal fee':.. `"-
Example: [15 divided by 23=.65(%)] $175(permit fee)x.65=$113.75(renewal fee)
Revised 7/21/2014
Associated Air of Port St Lucie, Inc
1552 Se. Niemeyer Circle
Port St Lucie, FL 34952 lic. Cac057622 RECEIVED
APR 17 2018
ST. Lucie county, permitting
Planning and development services
Building and code regulation division
2300 Virginia Ave
Fort Pierce, F134982
Building official or other,
Associated Air of Port St Lucie is formally requesting an extension for permit#1708-
0580
Because of hold ups and delays to the job we were not able to complete it before the
Allotted 6 months.
Thank you,
Mike Krencik
Associated Air of Port St Lucie
772-335-7089
Cac057622
26789