HomeMy WebLinkAboutPermit Renewals PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE RECEIVED
FORT PIERCE,FL 34982
(772)462-1553 Fax(772)462-1578
MAY 14 2018
PERMIT RENEWAL REQUES ST. Lucie C®untY#PprMlttl22
PERMIT NUMBER:� Y� ADDRESS:
14 Dennis Zacek ,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
—TI )e
t z
OWNERIBLDR OR CONTR&nOR SIGNATURE DATE
Dennis Zacek
Print Name
STATE OF FLORIDA
COUNTY OF ST Lucie
ACKN014`LEDGED BEFORE ME THIS-'i—�--DAY OF 20ff—
BY Dennis Zacek WHO IS PERSONALLY KNOWN TO ME X OR
HAS PROVIDED AS IDENTIFICATION.
COLEEN SULUVAN
!kQNA1M-'0F N014.&Y MY COMMISSION#G0071535
EXPIRES Febnory 09.2021
FOR OFFICE USE ONLY:
Numberol'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)e.65=$113.75(renewal fee)
Revised 7P-IP-014