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 REQUEST NOV 05 2018
ST. Lucie County, Permitting
PERMIT NUMBER:� �CJ� ADDRESS: %ca ��
I,_�2nn15 Z2c2K , 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
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11 '
OWNER/BLIN OR CONTRACTOR SIGNATURE l \ ATE
I ' hl5 Zaw
Print Name
STATE OF FLORID ,
COUNTY OF 5 f. U,�)e ��
ACKNOWLEDGED BEFORE ME THIS AY OF �� ,20
BY L `1 tma WHO IS PERSONALLY KNOWN TO ME 1/ ,OR
HAS PROVIDED AS IDENTIFICATION.
SOF FLORID , o f . un e
COLEEN SULLIVANGNATURE OF ARY S rptt� `°: MY COMMISSION#GG071535
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(perm�it fee)x.65=$113.75 (renewal fee)
Revised 7/2112014