HomeMy WebLinkAboutPermit renewal 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
PERMIT RENEWAL REQUEST pQfm SR
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PERMIT NUMBER: 1708-0685 ADDRESS: 134 NE TUNISON AVE
1, GARY FERRIS ,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.
Justificat- MISCOMUNICATION
04/09/2018
OW&ER/BLDA OR CMqTRACTOR SIGNATURE DATE
GARY FE RIS
Print Name
STATE OF FLORIDA
COUNTY OF ST LUCIE
ACKNOWLEDGED BEFORE ME THIS 9TH DAY OF APRIL 2018
BY GARY FERRIS WHO IS PERSONALLY KNOWN TO ME X ,OR
HAS PROVIDED AS IDENTIFICATION.
STATE OF FLORID countyof ST L U C I E
EMANUEL GAGE
SIGNATURE OF NOTARY Si nl. MY COMMISSION#GG116741
W.
EXPIRES June 20,2021
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: 115 divided by 23=.65(0/o)] $175(permit fee)x.65=$113.75(renewal fee)
Revised 7/21/2014