HomeMy WebLinkAboutPermit Renewals PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
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BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE,FL 34982
(772)462-1553 Fax(772)462-1578
RECEIVED
PERMIT RENEWAL REQUEST MAY 2 3 2018
ST. Lucie County, Permittln
PERMIT NUMBER: a as d ADDRESS:
1, 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
S 23 - 2alg
OWNER/BLDR OR CONTkACTOR SIGNATURE DATE
�!i7v si
Prinf Name
STATE OF FLORIDA
COUNTY OF Sir L J c-
ACKNOWLEDGED BEFORE ME THIS a.3 DAY OF m a1 '20 VA
BY S.,3t< %.>e % r WHO IS PERSONALLY KNOWN TO ME OR
HAS PROVIDED L 0C- AS IDENTIFICATION.
STATE OF FLORIDA,County of S A,- L ��l
DEANNA MARIE GIVENS
COMMISSION#GG 022023
SIGNATURE OF NO RY '* ;o EI(ptG�ipecember 16,2020
ap,� Po Bonded ThN Notary Fubiic Undenvrito�i
FOR OFFICE USE ONLY:
Number of Open Inspections:
Total Inspections:
(Divide open by total to get%of open inspections) P.a,`^ .z
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 O\d
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