HomeMy WebLinkAboutPermit Renewals Jul 30 18 02:52p 772-336-9032 772-336-9032 p.2
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 3 1 2018
ST. Lucie Coun' Pt?rmitting
PERMITNUMBER: 1608-0446 ADDRESS: 5407 Myrtle Drive
I, Jacques Stiegelman ,am requesting that the above permit be renewed. I
understand that I must schedule and pass all required inspections for the permit to be firialed. 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 Somehow it slipped•thru the cracks, possibly due to a change in office staff.
Trying et it cleared
07130/18
OWNE LDR OR CONTRACTOR SIGNATURE DATE
Jacques Stiegelman
Print Name
STATE Or FLORID.
COUNTY OF. <e..
ACKNOWLEDGED BEFORE ME THIS DAY OF 2011—
By �l {e—Q d OAaf-A WHO IS PERSONALLY KNOWN TOME � ,OR
HAS PROVIDED hJ L�vv t� AS IDEVTIFICATION.
STA OF FLORIDA; ty, P .ar1-. 4+ - 1p__ Kristina R_Parsons
NOTARY PUBLIC
0 d� STAVE OP FLORIDA
I ATURE OF NO ARY SEAL P -(. Comm#GG090836
Expires 4/2312021
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 = $_4f�Renewal fee
Example: [15 divided by 23=.65(%)] $175(permit fee)x.65=$113.75(renewal fee)
Revised 7121.2014