HomeMy WebLinkAboutMisc Letters PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS IfIVISION
2300 VIRGINIA AVE
FORT PIERCE,FL 34982
(772)462-1553 Fax(772)462-1578
PERMIT RENEWAL REQUEST
PERMIT NUMBER: 1711-0496 ADDRESS: 5214 BOWLING GREEN DR, FORT PIERCE
I, Roderick Waller ,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 Forgot, thought it was part of renovation permit
10/8/18
OWNERBLDR OR CONT It
CTO SIGNATURE DATE
RODERICK WALLER
Print Name
STATE OF FLORIDA
COUNTY OF ST LUCIE
ACKNOWLEDGED BEFORE ME THIS 8th DAY OF October 2018
BY RODERICK WALLER WHO IS PERSONALLY KNOWN TO ME X OR
HAS PROVIDED AS IDENTIFICATION.
STAT F FLO DA,Countv of ST LUCIE
CPNNotary Public State of Florida
Sophia Harris
,,�g My Commission GG 238873
SIGNATU OF NOTAR •a9�EAL Expires 05/3012040
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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
LJ") `pt,
OCT 10 2.098