HomeMy WebLinkAboutPermit Renewals PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
-- -- - - - FORT PIERCE,FL 34982 RECEIVED
(772)462-1553 Fax(772)462-1578
NOV 0 5 2018
PERMIT RENEWAL REQU", Lucie county, Permitting
PERMIT NUMBER —O ADDRESS:
-41 fln (An
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
DeAnib *-4 Ed
OWNER/BLI&-6R CONTRACTOR SIGNATURE ATE
1 nA15 ZaCeK
Print Name
STATE OF FLORIDA
COUNTY OF L(��) ind
ACKNOWLEDGED BEFORE ME THIS i--DAY OF �• 1r ,20ACL
BY � �� WHO IS PERSONALLY KNOWN TOME 1/ OR
HAS PROVIDED AS IDENTIFICATION.
S OF FLORID oOf �. �11e
1),
E4,
GNATURE OF SEAL
; COLEEN SULLIVANMY COMMISSION#GG07153F EXPIRES Feb
ruary 09,202-1
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 = $ 5 _Renewal fee
Example: [15 divided by 23=.65(%)] $175(permit fee)x.65=$113.75 (renewal fee)
Revised 7/21/2014
14