HomeMy WebLinkAboutPermit Renewals PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
- BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE,FL 34982
(772)462-1553 Fax(772)462-1578 RECEIVED
PERMIT RENEWAL REQUEST JUL 10 2018
ST. Lucie County, Permitting
PERMIT NUMBER: �1 1� 5 ADDRESS: 5o\-4 ��—
I,�L(,,G 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
OWNER/BLDR OR CONTRACTOR SIGNATURE DATE
V1 4d C I �,�. (fo !l�
Print Name
STATE OF FLO DA-
COUNTY OF .
ACKNOWLEDGED BEFORE ME THIS O DAY OF J 4 ,20
BY W•� �1 Q"�'� L I`�3 WHO IS PERSONALLY KNOWN TO ME OR
HAS PROVIDED L_ AS.IDENTIFICATION.
STATE OF FLORIDA,County of S�' . L J c
�DEANNAMARIEGIVE '
SIGNATURE OF NO Y _ * M/IMISSION#GG 0220'23
EXPIRES:December 16,l}2u
Bonded Thru Notary Public Undensri),z
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