HomeMy WebLinkAboutPermit Renewals PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
s _ BUILDING AND CODE REGULATIONS DIVISIONLRECEIVED 2300 IRCI\IA r11 E
FORT PIERCE,FL 34982
(772)•362-1533 Fax(772) 362-1578
2018
PER HT RENEWAL REQUEST . PIPM;4tog,
PERMITNUNIBER: , -j,I ��o�i ADDRESS: � C • �� 1MCA , C,� \\�
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 inspe Z! Ing during any six month period during the renewal period.
Justification SUVA �(� C C)a:V Zk Y-��(Q a— cg j c
011'NER/BLDR OR CONI RVI OR SIUNA'I URF DATE
Dennis Zacek
Print Name
STATE OF FLORIDA
COUNTY OF ST L-
ACKNOWLEDGED BEFORE AIE 11115 DAY OF�`= 20-a^
BY Dennis ZacekWHO IS PERSONALLY KN'O"'N 1'0 NIE X OR
HAS PROVIDED AS IDENTIFICATION.
1T OF OR A, n of ST Lucie :��� COLEEN SULLIVAN
:�P' "�"
MY COMMISSION 9 GG071535
1 TUR h 'TA SEAS. �!„ EXPIRES February 04,2021
FOR OFFICE USE ONLY: �--------------�.~---------
Number of Open Inspections:
Total Inspections: 5 G
(Divide open by total to get%of open inspections)
Percentage:
Original permit fee: x%open = $ Rene«al fee
Example: [15 di%ided by 23=.65(%)j S175(permit fee)x.65=Si 13.75(renewal fee)
Rei tsed 7,.1;-10 14