HomeMy WebLinkAboutPermit Renewals PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
_ 2300 VIRGINIA AVE
FORT PIERCE,FL 34982
RECEIVED (772)462-1553 .Fax(772)462-1578
APR 2 6 2018 PERMIT RENEWAL REQUEST
ST. Lucie County, Permitting
PERMIT NUMBER: n ADDRESS:
i, ,j�''•v '`L�a�;� ,am requesting that the above permit be renewed. I
understand th t I inust 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 �v�
OWNER/BLDR OR CONTZA CTOR SIGNATURE DATE
Print Name
STATE OF FLO
COUNTY OF
AC OWLEDGED BEFORE ME THIS?1 e DAY OF 20-a—
BY WHO IS PERSONALLY KNOWN TO ME ,OR
HAS PROVIDED AS IDENTIFICATION.
STATE FLO A,Coun 'bf
KAREN S. NIELSEN
SIGNATUR�OO ARSEAL Co Y mission t FF 1 t 5,37
My Comrcussior, Fxp res
,�c,-e•.p. June 1 2, 201 8
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(%)] $175(permit fee)x.65=$113.75(renewal fee)
Revised 7/21/2014