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 REQUESS T NOV 05 2018
ST. Lucie County, Perrnitting
PERMIT NUMBER: I� lQ� ADDRESS: 44
I, , 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
MrNER/BL29 OR CONTRACTOR SIGNATURE DATE
i enn15 zaceK
Print Name
STATE OF FLORID
COUNTY OF �to
JnAY ACKNOWLEDGED BEFORE ME THIS OF D ,20-19—
BY I a `b Z�,. WHO IS PERSONALLY KNOWN TO ME ,OR
HAS PROVIDED AS IDENTIFICATION.
S OF FLORID o f �. Lua?
•;I""° COLEEN SULLIVAN
GNATURE OF ARY g MY COMMISSION#GG071535
EXPIRES February 09,2021 ;
i
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 = Renewalfee
Example: [15 divided by 23=.65(%)] $175(permit fee)x.65=$113.75(renewal fee)
Revised 7/21/2014
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