HomeMy WebLinkAboutPermit Renewal (1) PLANNING AND DEVELOPMENT['SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
• - 2300 VIRGINIA AVE
'FORT PIERCE,PL 34"2
(772)462-IM Fax(772)462-1578
PERMIT RENEWAL REQUEST
PERM IT NUMBER;: J-7 O JH ADDRESS: 6 Z,(0 7 #Ly r e iA
I, Peter A Cafaro III ,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 during any six month period during the renewal period.
Justification
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OWNS LDR QIP CON VRACIGNATURE DATE
Peter Gafaro ill
Print N e
STATE OF FLORIDA
COUNTY OF ORMOE
ACKNOWLEDGED BEFORE ME THIS IAt. DAY OF 20�
BY Peter A Cafaro III WHO IS PERSONALLY KNOWN TO ME OR
NAS PROVIDED AS IDENTIFICATION.
STATE OFFLORIDA.County o Gran
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G R NOTA S •1i !.t4!Nitorida
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FUR OFFICE USE ONLY;
Numberofopen Inspections:
Total Inspections:
(Divide open by total to get%of open inspections)
Percentage:
Original permit fee: x%open = S Renewal fee
Example:. [15 divided by 23=.65(%)] $175(permit fee)x.65=S 113.75(renewal fee)
Revised 712112014