HomeMy WebLinkAboutPermit Renewals- PLANNING A.ND DEVELOPMFNT SERVICES DEPARTMENT
' BUILDING AND CODE REGULATIONS DMSION
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2300 VIRGINIA AVE
FORT PIERCE,FL 34982
(772)462-1553 Fax(772)462-1578 RECEIVED
PERMIT RENEWAL REQUEST MAY 14 2018
ST. Lucie Caunty, Permitting
PERMIT NUMBER:,`,,- ADDRESS: ,.
1 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
0\VNr-R/BLDR OR CONT 'OR SIGNATURE DATE
Dennis Zacek
Print Name
STATE OF FLORIDA
COUNTY OF ST
ACKNOWLEDGED BEFORE ME THIS �.11 DAY OFW�NA �- 20
BY Dennis Zacek WHO IS PERSONALLY KNOWN TO ME X OR
HAS PROVIDED AS IDENTIFICATION.
ST F OjAount ST Lucie
CULEEN SULLIVANS SEAL
... MY COMMISSION N GG071535
EXPIRES February 08,2021
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(1o)] S175(permit fee)x.65=S113.75(rene�%Ul fee)
Revised 7r-1/'_{�14