HomeMy WebLinkAboutPermit Renewals PLANNING AND DEVELOPMENT SERVICES DEPAR'T'MENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIR.GINLA AVE - --
.._....__ .. _. FORT PIERCE,FL 34982 RECEIVED
(772)4624553 Fax(772)462-1578
MAY 31 291$
A i PERMIT RENEWAL REQUE�T
Y: SI Luue County, Permitting
1
PERMiT NUMBER: 1 1" O� c ADDRESS: i oay (!A
1, r ( requestii)g that the above permit be renewed. J
undePrststag that J must s�edul�
ass 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 1 trot receive a
passing inspection during any six month period during the renewal period.
J tibcation
OW R/B1L R NT RA DATE
Print ante ��►�; CHRIPNEWALMN
* *MY COMtA19810N!1 C�0 071164
x '�r t MIALS;May 14,2011
STATE OFFLORIDA ^�- oF"° ftOWThm8;u etNatary&Mo"
COUNTY Or•
ACKNOWLEDGED BEFORE ME THIS 2�L�AY OP yln(-y 20_IZ_
BY J r r-j �!/u�: Pi;51J11) WFIO IS PERSONALLY KNOWN TOME ✓ OR
HAS PROVIDED A5 IDENTIPICAT10N.
STATE OF FLORIDA.County of �'-<_
rrq 0"TINE%AK o
MY CAI�MISBION M OQ tlf 1161
SIGNATC71 4P NOTARY T E%PIRM:MaY 14,2021
�'4'oF r4°��Bonded Thn'B"dDe{NotMY Be�'A�
1, f
FOR OFFICE USE ONLY:
Number of Open)nspeations-
Total lnspections:
(Divide open by total TO get%otopen i:tspectidns)
Percentage:
Original permit fee: x%open = S Renewal fee
Example: [15 divided by 23=.65(%)j S175(permit fee)x.65=S113.75(renewal fee)
Revised 7/2112034