HomeMy WebLinkAboutPermit Renewals APR-24-2018 TUE 01 : 55 PM CENTRAL SCHEDULING FAX No. 3212686138 P- 002/002
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
. BUILDING AND CODE REGULATIONS DIVISION
•
2300 VIRGINIA AVE
FORT PIERCE,FL 34982
(772)462-1553 Fax(772)462-1578 RECFIV�D
PERMIT RENEWAL REQUES ST APR 2 5 -0118
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PERMIT NUMBER: `V 0ZTrDADDRESS: QNW 0
I, X Q ,am requestin�that the above permit be renewed. I
understand that I must schedule and pass all required inspeettons 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 inspecti n during any six z nth period during th renewal period.
Justification 1
1
OWN1E DR OR CONTRACTOR SIGNATURE ATB
ILC
STATE OF FLORID
COUNTY OF
ACKNOWLEDGED BEFORE ME THIS��DAY OF ,20
BY WHO IS FERSONALLY KNOWN TO ME_ ,OR
HAS PROVIDED ( l ,� t AS IDENTIFICATION.
ST TE 0 ORIDA,County of ll►fl \��� s`'��h'&'% Catherine Ko r
5 'CoatmIssion#PF17722372
aa— Lx =Expires:OCP 28,2018
ATM OF NOTARY S>ALBorn TrtRU
••In ,`'�` ISTFLOR) aD NOTARXLLG
FOR 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(%)] V75(permit fee)x.65=$113.75(renewal fee)
Advised 7/21/2014