HomeMy WebLinkAboutPermit Renewals PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
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ji-Ij BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE,FL 34982
(772)462-1553 Fax(772)462-1578 RECEIVED
PERMIT RENEWAL REQUE T JUN 19 2018
ST. Lucie County, Permitting
PERMIT NUMBER: / f O 7 ADDRESS:� �0� �NP Qe 44
I, R( Gc ,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 ring any six month peri durin he renewal period.
Justification 2 D
120
OWNER/BLDR OR CONTRACTOR SIGNATURE DATE
1912
Print Name
STATE OF FLORIDA
COUNTY OF %k. W t\�
ACKNOWLEDGED BEFORE ME THIS�_DAY OF V h 20X
BY R���na r4, 1 c-1G I,J,I�� WHO IS PERSONALLY KNOWN TO ME ,OR
HAS PROVIDED t✓ 11.) AS IDENTIFICATION.
t'Ar° DEANNAMARIEGWNS
ATE OF FLORIDA,County of
MY COMMISSION#GG 022023 +ov
o EXPIRES:December 16,2020 f
Bonded 7hru Notary pi biic Undervrl;e
SIGNATURE OF NOTARY
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(%)] $175(permit fee)x.65=$113.75 (renewal fee)
Revised 7/21/2014