HomeMy WebLinkAboutPermit Renewals PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
- - -- FORT PIERCE,FL 34982 RECEIVED
(772)4624553 Fax(772)462-1578
NOV 05 2018
PERMIT RENEWAL REQUEST ST. Lucie County, Permitting
PERMIT NUMBER: y —✓ ADDRESS-1026 O=OQ� On OLE,
I, nniS Z2_eK ,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
Lc6 .
OWNERIB1,22 OR CONTRACTOR SIGNATURE DATE
10-nA15 2AceK
Print Name
STATE OF FLORID
COUNTY OF �d
ACKNOWLEDGED BEFORE ME THIS �AY OF � � ,20 I o-
BY � ln �Z�aWHO IS PERSONALLY KNOWN TO ME OR
HAS PROVIDED AS IDENTIFICATION.
S OF FLORID o f �1
�. UJe
VI h'�V �s`r°� COLEEN SULLIVANILA
%NATURE OF T17MARY SEA 13.,A50-
, g�= MY COMMISSION#GG071535
, `50- EXPIRES February 09,2021
'
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: [15 divided by 23=.65(%)] $175(permit fee)x .65=$11'3.75 (renewal fee)
Revised 7/21/2014